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General NPI Number Information
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NPI Number | 1487609798
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Entity Type | Organization
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Legal Business Name | WM. L. O'NEILL, DDS, PA
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2611 BOLTON BOONE DR
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City | DESOTO
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State | TX
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Zip | 75115-2011
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Country | US
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Telephone | 972-296-9976
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Fax | 972-296-2280
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Provider Business Mailing Address
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Address Line | 7722 LA BOLSA DR
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City | DALLAS
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State | TX
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Zip | 75248-4335
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Country | US
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Telephone | 214-542-9018
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM LEE O'NEILL
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Credential | D.D.S.
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Telephone | 214-542-9018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 13788
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License Number State | TX
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