Provider Demographics
NPI:1265655906
Name:CONNOR, ROBERT BLACKSHER (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BLACKSHER
Last Name:CONNOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:BLACKSHER
Other - Last Name:CONNOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1771 INDEPENDENCE CT
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-870-9871
Mailing Address - Fax:205-870-9875
Practice Address - Street 1:1771 INDEPENDENCE CT
Practice Address - Street 2:SUITE 1
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-870-9871
Practice Address - Fax:205-870-9875
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist