Provider Demographics
NPI:1336665934
Name:DRS. O'NEAL, BISHARA & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DRS. O'NEAL, BISHARA & ASSOCIATES, LLC
Other - Org Name:RIVERTOWNE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-567-3122
Mailing Address - Street 1:6188 OXON HILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3157
Mailing Address - Country:US
Mailing Address - Phone:301-567-3122
Mailing Address - Fax:
Practice Address - Street 1:6188 OXON HILL RD STE 200
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3157
Practice Address - Country:US
Practice Address - Phone:301-567-3122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty