Provider Demographics
NPI:1447283684
Name:CONNOR,III, THOMAS W (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:CONNOR,III
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E REDD RD BLDG 1-B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7221
Mailing Address - Country:US
Mailing Address - Phone:915-581-1771
Mailing Address - Fax:915-581-5772
Practice Address - Street 1:840 REDD RD
Practice Address - Street 2:BLDG 1-B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912
Practice Address - Country:US
Practice Address - Phone:915-581-1771
Practice Address - Fax:915-581-5772
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice