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General NPI Number Information
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NPI Number | 1619205721
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Entity Type | Organization
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Legal Business Name | DR. SHAUN O'HEARN, DDS, PA
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 1445 TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2803
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Country | US
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Telephone | 828-298-9928
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Fax | 282-298-9908
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Provider Business Mailing Address
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Address Line | 1445 TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2803
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Country | US
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Telephone | 828-298-9928
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Fax | 282-298-9908
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | SHAUN O'HEARN
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Credential | DDS
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Telephone | 828-298-9928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7561
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License Number State | NC
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