Provider Demographics
NPI:1457975583
Name:ENGLISH, CONNOR (DMD)
Entity type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:
Last Name:ENGLISH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9331 SPRINGBROOKE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-3007
Mailing Address - Country:US
Mailing Address - Phone:502-751-4101
Mailing Address - Fax:
Practice Address - Street 1:CARIUS DENTAL CLINIC BLDG#P3020
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-5244
Practice Address - Country:US
Practice Address - Phone:315-737-9186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist