Provider Demographics
NPI:1760937346
Name:CONNOR, DUSTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:CONNOR
Suffix:
Gender:M
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:UNIT 23810 BOX 62
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09034-3810
Mailing Address - Country:US
Mailing Address - Phone:314-590-1009
Mailing Address - Fax:
Practice Address - Street 1:BLDG 8647 DENTAL STREET
Practice Address - Street 2:
Practice Address - City:BAUMHOLDER
Practice Address - State:RHEINLAND PFALZ
Practice Address - Zip Code:55774
Practice Address - Country:DE
Practice Address - Phone:314-590-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.24893122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist