Provider Demographics
NPI:1760520076
Name:O'NEILL, JAMIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:POOLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2727 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1847
Mailing Address - Country:US
Mailing Address - Phone:419-536-9196
Mailing Address - Fax:419-536-2835
Practice Address - Street 1:2727 N HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE B
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1847
Practice Address - Country:US
Practice Address - Phone:419-536-9196
Practice Address - Fax:419-536-2835
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0224571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice