Provider Demographics
NPI:1881678498
Name:CONDUFF, JOSEPH HOWARD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HOWARD
Last Name:CONDUFF
Suffix:JR
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 1:103 WEST MAIN ST.
Mailing Address - Street 2:P. O. BOX 113
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-2380
Mailing Address - Country:US
Mailing Address - Phone:540-745-4171
Mailing Address - Fax:540-745-4171
Practice Address - Street 1:103 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-2380
Practice Address - Country:US
Practice Address - Phone:540-745-4171
Practice Address - Fax:540-745-4171
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010069051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice