MEDICARE: DR. THOMAS ANDREW CONNER D.D.S.

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
1	122300000X	Dentist	0401007258	VA

General Provider Information

NPI Number	:	1578863403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ANDREW CONNER D.D.S.

Provider Business Mailing Address
First Line	:	9510 IRON BRIDGE RD
Second Line	:	SUITE 100
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-6400
Country	:	US
Telephone Number	:	804-768-7600
Fax Number	:	804-768-0115

Provider Business Practice Location Address
First Line	:	9510 IRON BRIDGE RD
Second Line	:	SUITE 100
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-6400
Country	:	US
Telephone Number	:	804-768-7600
Fax Number	:	804-768-0115

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2010
Last Update Date	:	06/27/2016

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