Provider Demographics
NPI:1902902968
Name:OCONNOR, PATRICK EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:EDWARD
Last Name:OCONNOR
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 1:1400 W IMPERIAL HWY
Mailing Address - Street 2:I
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631
Mailing Address - Country:US
Mailing Address - Phone:562-690-7796
Mailing Address - Fax:562-690-3340
Practice Address - Street 1:1400 W IMPERIAL HWY
Practice Address - Street 2:I
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631
Practice Address - Country:US
Practice Address - Phone:562-690-7796
Practice Address - Fax:562-690-3340
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA280551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice