Provider Demographics
NPI:1942301247
Name:O'NEAL, STEVEN MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARTIN
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 1:4290 KINSEY DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1024
Mailing Address - Country:US
Mailing Address - Phone:903-561-0533
Mailing Address - Fax:903-561-0630
Practice Address - Street 1:4290 KINSEY DR
Practice Address - Street 2:SUITE 3
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1024
Practice Address - Country:US
Practice Address - Phone:903-561-0533
Practice Address - Fax:903-561-0630
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice