Provider Demographics
NPI:1053649707
Name:O'REILLY, JUNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 732
Mailing Address - Street 2:
Mailing Address - City:AMAGANSETT
Mailing Address - State:NY
Mailing Address - Zip Code:11930-0732
Mailing Address - Country:US
Mailing Address - Phone:631-267-6759
Mailing Address - Fax:631-267-2097
Practice Address - Street 1:12 GARDINER DR.
Practice Address - Street 2:
Practice Address - City:AMAGANSETT
Practice Address - State:NY
Practice Address - Zip Code:11930-0732
Practice Address - Country:US
Practice Address - Phone:631-267-6759
Practice Address - Fax:631-267-2097
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0355851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice