Provider Demographics
NPI:1982866885
Name:CONRAD, TORI-THUY THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:TORI-THUY
Middle Name:THI
Last Name:CONRAD
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 1:2665 W 78TH ST
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4502
Mailing Address - Country:US
Mailing Address - Phone:612-834-1664
Mailing Address - Fax:952-223-6865
Practice Address - Street 1:2665 W 78TH ST
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4502
Practice Address - Country:US
Practice Address - Phone:612-834-1664
Practice Address - Fax:952-223-6865
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND125621223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry