| Larry J Oneill Dmd Pc | |
|
779 Crossroads Circle Elizabeth CO 80107-2466 | |
| (720) 646-3935 | |
| (303) 379-5380 |
| Full Name | Larry J Oneill Dmd Pc |
|---|---|
| Speciality | Dentist |
| Location | 779 Crossroads Circle, Elizabeth, Colorado |
| Authorized Official Name and Position | Larry J Oneill (PRESIDENT) |
| Authorized Official Contact | 3036463935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry J Oneill Dmd Pc 779 Crossroads Cr Elizabeth CO 80107-2466 Ph: (303) 646-3935 | Larry J Oneill Dmd Pc 779 Crossroads Circle Elizabeth CO 80107-2466 Ph: (720) 646-3935 |
| NPI Number | 1760084826 |
|---|---|
| Provider Enumeration Date | 11/13/2020 |
| Last Update Date | 03/25/2021 |
| Medicare PECOS PAC ID | 5799939179 |
|---|---|
| Medicare Enrollment ID | O20210201000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760084826 | NPI | - | NPPES |
| 1386905057 | Other | NPPES | |
| 1760084826 | Other | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| Provider Name | Larry J Oneill |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1174521348 PECOS PAC ID: 3678728797 Enrollment ID: I20210208001857 |
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