| Doctor Name: | MS. CAROLYN ANN CONRAD |
| NPI Number: | 1427325596 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RDHAP |
| License Number: | |
| Business Practice Address: | 18011 River Circle Suite #4 Canyon Country, CA - 91387 |
| Business Phone Number: | 6616452809 |
| Business Fax Number: | 6612519333 |
| Mailing Address: | 18011 River Circle, Suite #4 CANYON COUNTRY |
| State: | CA |
| Postal Code: | 91387 |
| Phone Number: | 6616452809 |
| Fax Number: | 6612519333 |
| NPI Enumeration Date: | 11/17/2011 |
| NPI Last Update Date: | 11/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |