Provider Demographics
NPI:1982615951
Name:O'CONNOR, BETH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:A
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 1:9618 59TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2799
Mailing Address - Country:US
Mailing Address - Phone:253-584-2124
Mailing Address - Fax:253-588-1463
Practice Address - Street 1:9618 59TH AVE SW
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98499-2799
Practice Address - Country:US
Practice Address - Phone:253-584-2124
Practice Address - Fax:253-588-1463
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist