Individual
JOHN OMALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2007 RANDOLPH RD, CHARLOTTE, NC 28207-1233
(704) 374-1221
Mailing address
1928 TRILLIUM LN, CHARLOTTE, NC 28211-4445
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3852
NC
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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