Provider Demographics
NPI:1285786319
Name:JEFFREY E ONEIL DDS PA
Entity type:Organization
Organization Name:JEFFREY E ONEIL DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ONEIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-866-2233
Mailing Address - Street 1:6945 PENN AVENUE SOUTH SUITE 101
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423
Mailing Address - Country:US
Mailing Address - Phone:612-866-2233
Mailing Address - Fax:612-866-2341
Practice Address - Street 1:6945 PENN AVENUE SOUTH SUITE 101
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423
Practice Address - Country:US
Practice Address - Phone:612-866-2233
Practice Address - Fax:612-866-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty