| Mary M. O'connor, Dds, Inc | |
|
420 Spruce St Ste A San Diego CA 92103-5859 | |
| (619) 291-5291 | |
| (619) 291-9755 |
| Full Name | Mary M. O'connor, Dds, Inc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 420 Spruce St Ste A, San Diego, California |
| Authorized Official Name and Position | Mary Mildred O'connor (PRESIDENT) |
| Authorized Official Contact | 6192915291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary M. O'connor, Dds, Inc 420 Spruce St Ste A San Diego CA 92103-5859 Ph: (619) 291-5291 | Mary M. O'connor, Dds, Inc 420 Spruce St Ste A San Diego CA 92103-5859 Ph: (619) 291-5291 |
| NPI Number | 1700070646 |
|---|---|
| Provider Enumeration Date | 09/04/2007 |
| Last Update Date | 09/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700070646 | NPI | - | NPPES |
| 514126 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 38072 (California) | Primary |
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