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DR. DOUGLAS PATRICK O'CONNOR D.M.D.

>> Dentist >> Dental Providers

Registrant NPI Number: 1962535112

Individual Registrant:
DR. DOUGLAS PATRICK O'CONNOR D.M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
104 HILLCREST DR  EVERGREEN, AL 36401 US
Tel: 251-578-4444  Fax: 251-578-4444

Contact information for business:
PO BOX 429  EVERGREEN, AL 36401 US
Tel: 251-578-4444  Fax: 251-578-4444

Registration Information:
NPI: 1962535112
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AL5089

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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