Provider Demographics
NPI:1063582906
Name:O'MEARA, FRANK P (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:P
Last Name:O'MEARA
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 1:6351 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1401
Mailing Address - Country:US
Mailing Address - Phone:773-232-7300
Mailing Address - Fax:773-262-1237
Practice Address - Street 1:6351 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1401
Practice Address - Country:US
Practice Address - Phone:773-232-7300
Practice Address - Fax:773-262-1237
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01900167311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice