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DR. JON W. CONRAD D.O.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1336111343

Individual Registrant:
DR. JON W. CONRAD D.O.
Gender: M
Sole Proprietor

Location and contact information for practice:
808 WILLOW ST  COFFEYVILLE, KS 67337-5851 US
Tel: 620-251-3920  Fax: 620-251-3923

Contact information for business:
808 WILLOW ST PO BOX 374 COFFEYVILLE, KS 67337-5851 US
Tel: 620-251-3920  Fax: 620-251-3923

Registration Information:
NPI: 1336111343
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
KS5417

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD08906KS01




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