Provider Demographics
NPI:1104498948
Name:CONNORS, CLARE (DMD)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:CONNORS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 WASHINGTON ST APT 15
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4556
Mailing Address - Country:US
Mailing Address - Phone:404-579-1381
Mailing Address - Fax:
Practice Address - Street 1:1 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1662
Practice Address - Country:US
Practice Address - Phone:508-466-7091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist