Provider Demographics
NPI:1316150584
Name:O'CONNELL, DANIEL J (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:O'CONNELL
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 1:254 S MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3340
Mailing Address - Country:US
Mailing Address - Phone:845-638-0900
Mailing Address - Fax:
Practice Address - Street 1:254 S MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3340
Practice Address - Country:US
Practice Address - Phone:845-638-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist