Individual
DR. GRACE A. O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
052224-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052224-1
LICENSES
NY
01
—
113465690
TAX ID
NY
Enumeration date
08/07/2006
Last updated
08/14/2020
Update your record
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