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General NPI Number Information
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NPI Number | 1932311636
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Entity Type | Organization
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Legal Business Name | ROBERTMONEILLDDSINC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 20054 LAKE CHABOT RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5304
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Country | US
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Telephone | 510-886-1231
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Fax | 510-886-4736
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Provider Business Mailing Address
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Address Line | 20054 LAKE CHABOT RD
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5304
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Country | US
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Telephone | 510-886-1231
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Fax | 510-886-4736
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT MICHAEL ONEILL
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Credential | DDS
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Telephone | 510-886-1231
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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 | 21627
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License Number State | CA
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