# JOHN P OMALLEY DMD PA

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

## Provider details

- **NPI number:** 1558426874
- **Authorized official:** DR. JOHN PATRICK OMALLEY (PRESIDENT)
- **Authorized official phone:** (704) 374-1221

## Contact information

- **Practice address:** 2007 RANDOLPH ROAD, CHARLOTTE, NC 28207
- **Practice address phone:** (704) 374-1221
- **Practice address fax:** (704) 344-0834
- **Mailing address:** 2007 RANDOLPH ROAD, CHARLOTTE, NC 28207
- **Mailing address phone:** (704) 374-1221
- **Mailing address fax:** (704) 344-0834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 3852 | NC | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 03/04/2008