# KEVIN J. O'NEILL, D.D.S., M.S.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194980284
- **Authorized official:** DR. KEVIN JAMES O'NEILL D.D.S., M.S.D. (DOCTOR/ OWNER)
- **Authorized official phone:** (916) 786-3303

## Contact information

- **Practice address:** 10 SIERRA GATE PLZ, SUITE \#190, ROSEVILLE, CA 95678-6645
- **Practice address phone:** (916) 786-3303
- **Practice address fax:** (916) 786-3309
- **Mailing address:** 10 SIERRA GATE PLZ, SUITE \#190, ROSEVILLE, CA 95678-6645
- **Mailing address phone:** (916) 786-3303
- **Mailing address fax:** (916) 786-3309

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 25963 | CA | Yes |
| 1223E0200X | Endodontics | 39553 | CA | — |

## Other

- **Enumeration date:** 07/28/2008
- **Last updated:** 07/28/2008