MEDICARE: DR. JOSEPH HOWARD CONDUFF JR. 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	1223G0001X	General Practice Dentistry	0401006905	VA

General Provider Information

NPI Number	:	1881678498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH HOWARD CONDUFF JR. D.D.S.

Provider Business Mailing Address
First Line	:	103 WEST MAIN ST.
Second Line	:	P. O. BOX 113
City	:	FLOYD
State	:	VA
Zip	:	24091-2380
Country	:	US
Telephone Number	:	540-745-4171
Fax Number	:	540-745-4171

Provider Business Practice Location Address
First Line	:	103 WEST MAIN ST.
Second Line	:
City	:	FLOYD
State	:	VA
Zip	:	24091-2380
Country	:	US
Telephone Number	:	540-745-4171
Fax Number	:	540-745-4171

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

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	07/08/2007

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