Provider Demographics
NPI:1073818613
Name:O'NEIL, PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6491 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4728
Mailing Address - Country:US
Mailing Address - Phone:251-625-2525
Mailing Address - Fax:
Practice Address - Street 1:6491 JORDAN RD
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4728
Practice Address - Country:US
Practice Address - Phone:251-625-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics