Chester Lee Conner, DDS

Individual provider Active NPI General Practice Dentistry · Plymouth, NC

NPI 1619907227 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1619907227
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3661 (NC)
Practice address
363 Highway 64 West
Plymouth, NC 27962
Phone
(252) 793-5942
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3661NCMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3661 NC Yes

Addresses

Primary practice location

363 Highway 64 West
Plymouth, NC 27962

Mailing address

PO Box 9
Plymouth, NC 27962-0009
Phone (252) 793-5942

Other providers in Plymouth, NC

All providers in Plymouth, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.