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NPI Code Detail

MEDICARE: DR. GREGORY M. O'CONNOR D.D.S.

MEDICARE:  DR. GREGORY M. O'CONNOR  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry25282CA

General Provider Information

NPI Number : 1902877731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY M. O'CONNOR D.D.S.
Provider Business Mailing Address
First Line : 3178 COLLINS DR
Second Line : SUITE C
City : MERCED
State : CA
Zip : 95348-3132
Country : US
Telephone Number : 209-383-9222
Fax Number : 209-383-5372
Provider Business Practice Location Address
First Line : 3178 COLLINS DR
Second Line : SUITE C
City : MERCED
State : CA
Zip : 95348-3132
Country : US
Telephone Number : 209-383-9222
Fax Number : 209-383-5372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GREGORY M. O'CONNOR D.D.S.” Practice Location

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