Provider Demographics
NPI:1073629135
Name:CONNER, CATHERINE E (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:E
Last Name:CONNER
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Gender:F
Credentials:DDS, MS
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Mailing Address - Street 1:1215 JOHNSON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1353
Mailing Address - Country:US
Mailing Address - Phone:304-842-0590
Mailing Address - Fax:304-842-0591
Practice Address - Street 1:1215 JOHNSON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1353
Practice Address - Country:US
Practice Address - Phone:304-842-0590
Practice Address - Fax:304-842-0591
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WVWV27271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics