Provider Demographics
NPI:1598776676
Name:CONWAY & MATHEWS
Entity Type:Organization
Organization Name:CONWAY & MATHEWS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DS
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:813-754-3794
Mailing Address - Street 1:2005 THONOTOSASSA RD STE A
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-2972
Mailing Address - Country:US
Mailing Address - Phone:813-754-3794
Mailing Address - Fax:813-754-1677
Practice Address - Street 1:2005 THONOTOSASSA RD STE A
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-2972
Practice Address - Country:US
Practice Address - Phone:813-754-3794
Practice Address - Fax:813-754-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty