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NPI Code Detail

MEDICARE: DR. DANIEL JAMES O'CONNOR D.D.S.

MEDICARE: DR. DANIEL JAMES 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 Dentistry5315008096MI

General Provider Information

NPI Number : 1760555353
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL JAMES O'CONNOR D.D.S.
Provider Business Mailing Address
First Line : 7115 CADE RD
Second Line :
City : BROWN CITY
State : MI
Zip : 48416-9778
Country : US
Telephone Number : 810-989-0182
Fax Number :
Provider Business Practice Location Address
First Line : 7115 CADE RD
Second Line :
City : BROWN CITY
State : MI
Zip : 48416-9778
Country : US
Telephone Number : 810-989-0182
Fax Number : 810-346-2016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 07/08/2007

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