Provider Demographics
NPI:1518781087
Name:DR MICHAEL H CONNOR DDS MS PA
Entity type:Organization
Organization Name:DR MICHAEL H CONNOR DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-277-3300
Mailing Address - Street 1:12301 LAKE UNDERHILL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4509
Mailing Address - Country:US
Mailing Address - Phone:407-277-3300
Mailing Address - Fax:
Practice Address - Street 1:12301 LAKE UNDERHILL RD STE 107
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4509
Practice Address - Country:US
Practice Address - Phone:407-277-3300
Practice Address - Fax:407-277-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental