Provider Demographics
NPI:1245353606
Name:CONLON & THOMPSON ORTHODONTICS, LTD.
Entity type:Organization
Organization Name:CONLON & THOMPSON ORTHODONTICS, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CONLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:815-344-2840
Mailing Address - Street 1:4104 W CRYSTAL LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-4204
Mailing Address - Country:US
Mailing Address - Phone:815-344-2840
Mailing Address - Fax:815-344-2859
Practice Address - Street 1:4104 W CRYSTAL LAKE RD
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-4204
Practice Address - Country:US
Practice Address - Phone:815-344-2840
Practice Address - Fax:815-344-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty