Provider Demographics
NPI:1588842108
Name:DEBORAH ANN CONNER DDS PLLC
Entity Type:Organization
Organization Name:DEBORAH ANN CONNER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-416-4200
Mailing Address - Street 1:PO BOX 2565
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-2565
Mailing Address - Country:US
Mailing Address - Phone:919-416-4200
Mailing Address - Fax:919-416-4230
Practice Address - Street 1:922 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4147
Practice Address - Country:US
Practice Address - Phone:919-416-4200
Practice Address - Fax:919-416-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty