Provider Demographics
NPI:1093182768
Name:O'CONNOR, PAULETTE LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:LOUISE
Last Name:O'CONNOR
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 1:1611 S MELROSE DR
Mailing Address - Street 2:SUITE A #257
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-2405
Mailing Address - Country:US
Mailing Address - Phone:760-598-7565
Mailing Address - Fax:760-598-6034
Practice Address - Street 1:1631 S MELROSE DR STE I
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-2405
Practice Address - Country:US
Practice Address - Phone:760-598-7565
Practice Address - Fax:760-598-6034
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64976122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist