Organization
MARY M. O'CONNOR, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY MILDRED O'CONNOR D.D.S. (PRESIDENT)
(619) 291-5291
Entity
Organization
Contact information
Practice address
420 SPRUCE ST STE A, SAN DIEGO, CA 92103-5859
(619) 291-5291
(619) 291-9755
Mailing address
420 SPRUCE ST STE A, SAN DIEGO, CA 92103-5859
(619) 291-5291
(619) 291-9755
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
38072
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
514126
DENTI-CAL
CA
Enumeration date
09/04/2007
Last updated
09/04/2007
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