Provider Demographics
NPI:1154438356
Name:O'NEAL, GEORGE (DDS)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
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 1:820 NORTH VAN BUREN AVENUE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455
Mailing Address - Country:US
Mailing Address - Phone:903-572-5635
Mailing Address - Fax:903-572-1183
Practice Address - Street 1:820 NORTH VAN BUREN AVENUE
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455
Practice Address - Country:US
Practice Address - Phone:903-572-5635
Practice Address - Fax:903-572-1183
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist