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NPI Code Detail

MEDICARE: THOMAS E CONDRON DDS

MEDICARE: THOMAS E CONDRON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryWV1963WV

Other Identifiers

General Provider Information

NPI Number : 1457415135
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS E CONDRON DDS
Provider Business Mailing Address
First Line : 234 COURT ST
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-2906
Country : US
Telephone Number : 304-623-4984
Fax Number : 304-623-2830
Provider Business Practice Location Address
First Line : 234 COURT ST
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-2906
Country : US
Telephone Number : 304-623-4984
Fax Number : 304-623-2830
Authorized Official
Title or Position : DENTIST
Name : DR. THOMAS E CONDRON IX
Credential : D.D.S
Telephone Number : 304-623-4984
Provider Enumeration Date : 12/20/2006
Last Update Date : 03/14/2017

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Directions to “THOMAS E CONDRON DDS ” Practice Location

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