John Patrick Conry in Hermantown - Pediatric Dentistry
John Patrick Conry - NPI 1205958931
John Patrick Conry is a Pediatric Dentistry in Hermantown, Minnesota. John Patrick Conry practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for John Patrick Conry is 1205958931. The last update date is 2015-03-12.
John Patrick Conry's current location address is 4419 Air Base Road, Hermantown, Minnesota. You can contact this provider via phone number 2187282117 and fax number 2187282700. The mailing address for John Patrick Conry is 4419 Air Base Road, Hermantown, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John Patrick Conry |
|---|---|
| Address | 4419 Air Base Road, Hermantown, Minnesota |
| Phone Number | 2187282117 |
| Fax Number | 2187282700 |
| Sole Proprietor | N |
| Credentials | BDS MS |
NPI Number Detail
| NPI Number | 1205958931 |
|---|---|
| Provider Enumeration Date | 2007-04-04 |
| Last Updated Date | 2015-03-12 |
Provider Mailing Address Detail
| Address | 4419 Air Base Road |
|---|---|
| City | Hermantown |
| State | Minnesota (MN) |
| Post Code | 55811 |
| Phone Number | 2187282117 |
| Fax Number | 2187282700 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | D10837 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 447014100 | MN | MN CARE |
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What is the unique provider identifier assigned to John Patrick Conry?
The John Patrick Conry has been issued the NPI (National Provider Identifier) 1205958931 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the John Patrick Conry located?
The John Patrick Conry is located at 4419 Air Base Road, Hermantown, MN 55811.
What is John Patrick Conry's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for John Patrick Conry is Pediatric Dentistry, and the taxonomy classification code that categorizes this area of expertise is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1205958931 to John Patrick Conry?
The John Patrick Conry received its 1205958931 assignment from the Centers for Medicare & Medicaid Services on 2007-04-04.
When was the information regarding John Patrick Conry most recently updated?
The details pertaining to the John Patrick Conry, including its address, specialty, and other relevant information, were last refreshed on 2015-03-12.