Provider Demographics
NPI:1124306105
Name:O'CONNOR, RACHEL R (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:R
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:T
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7201 MONACO ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1720
Mailing Address - Country:US
Mailing Address - Phone:303-287-2755
Mailing Address - Fax:
Practice Address - Street 1:7201 MONACO ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1720
Practice Address - Country:US
Practice Address - Phone:303-287-2755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice