Provider Demographics
NPI:1225247380
Name:OCONNOR, JOHN THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3205
Mailing Address - Country:US
Mailing Address - Phone:781-259-8734
Mailing Address - Fax:
Practice Address - Street 1:67 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3205
Practice Address - Country:US
Practice Address - Phone:781-259-8734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist