Provider Demographics
NPI:1699188896
Name:O'CONNOR, AMBER DENISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:DENISE
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 1:1900 HI LINE DR APT 342
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3366
Mailing Address - Country:US
Mailing Address - Phone:817-269-6518
Mailing Address - Fax:
Practice Address - Street 1:2305 CEDAR SPRINGS RD STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7885
Practice Address - Country:US
Practice Address - Phone:214-969-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX299081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice