Provider Demographics
NPI:1386862746
Name:GERALD T ONEIL DMD PC
Entity type:Organization
Organization Name:GERALD T ONEIL DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ONEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-664-4336
Mailing Address - Street 1:85 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247
Mailing Address - Country:US
Mailing Address - Phone:413-664-4336
Mailing Address - Fax:413-664-4366
Practice Address - Street 1:85 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247
Practice Address - Country:US
Practice Address - Phone:413-664-4336
Practice Address - Fax:413-664-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA126031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty