Provider Demographics
NPI:1083358816
Name:CONNOR RIVERS PLLC
Entity Type:Organization
Organization Name:CONNOR RIVERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNOR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:417-379-1010
Mailing Address - Street 1:60 S 8TH ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1929
Mailing Address - Country:US
Mailing Address - Phone:970-963-3013
Mailing Address - Fax:
Practice Address - Street 1:60 S 8TH ST UNIT 201
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1929
Practice Address - Country:US
Practice Address - Phone:970-963-3013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental