Provider Demographics
NPI:1730485715
Name:CONKLIN, DEVON BYRNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:BYRNE
Last Name:CONKLIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 KENILWORTH DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2101
Mailing Address - Country:US
Mailing Address - Phone:410-583-7010
Mailing Address - Fax:
Practice Address - Street 1:1104 KENILWORTH DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2101
Practice Address - Country:US
Practice Address - Phone:410-583-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14559122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist