Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5896 | NE |
NPI | 1003893009 |
---|---|
Provider Name | Dr. Daniel James Convey |
First Address | Norfolk, NE 68701-4537 |
Second Address | Norfolk, NE 68701-4537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 12/09/2018 |