Provider Demographics
NPI:1780663385
Name:O'CONOR, CASEY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:L
Last Name:O'CONOR
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 1:35836 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3071
Mailing Address - Country:US
Mailing Address - Phone:440-327-9036
Mailing Address - Fax:440-327-7938
Practice Address - Street 1:35836 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3071
Practice Address - Country:US
Practice Address - Phone:440-327-9036
Practice Address - Fax:440-327-7938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-181601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics