Provider Demographics
NPI:1760555353
Name:O'CONNOR, DANIEL JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:O'CONNOR
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 1:7115 CADE RD
Mailing Address - Street 2:
Mailing Address - City:BROWN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48416-9778
Mailing Address - Country:US
Mailing Address - Phone:810-989-0182
Mailing Address - Fax:
Practice Address - Street 1:7115 CADE RD
Practice Address - Street 2:
Practice Address - City:BROWN CITY
Practice Address - State:MI
Practice Address - Zip Code:48416-9778
Practice Address - Country:US
Practice Address - Phone:810-989-0182
Practice Address - Fax:810-346-2016
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53150080961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice