Provider Demographics
NPI:1033268891
Name:O'NEAL, MARK H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:H
Other - Last Name:O'NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:6915 ANTOINE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1214
Mailing Address - Country:US
Mailing Address - Phone:713-682-6647
Mailing Address - Fax:713-682-6657
Practice Address - Street 1:6915 ANTOINE DR
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1214
Practice Address - Country:US
Practice Address - Phone:713-682-6647
Practice Address - Fax:713-682-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice