Provider Demographics
NPI:1982382933
Name:CONLEY, EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:CONLEY
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 1:331 GOAD DR
Mailing Address - Street 2:
Mailing Address - City:WRENSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:55797-5005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 TOWER AVE
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-1504
Practice Address - Country:US
Practice Address - Phone:732-392-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001247-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist