Provider Demographics
NPI:1457648545
Name:O'NEAL, CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:O'NEAL
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 1:190 COZINE AVE
Mailing Address - Street 2:GROUND FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-8867
Mailing Address - Country:US
Mailing Address - Phone:718-649-1398
Mailing Address - Fax:
Practice Address - Street 1:190 COZINE AVE
Practice Address - Street 2:GROUND FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-8867
Practice Address - Country:US
Practice Address - Phone:718-649-1398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057073122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist