Provider Demographics
NPI:1568682896
Name:O'LEARY DENTAL GROUP
Entity type:Organization
Organization Name:O'LEARY DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:GETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-774-9601
Mailing Address - Street 1:111 MAIN ST. WEST
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9412
Mailing Address - Country:US
Mailing Address - Phone:814-774-9601
Mailing Address - Fax:814-774-2055
Practice Address - Street 1:111 MAIN ST W
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-1613
Practice Address - Country:US
Practice Address - Phone:814-774-9601
Practice Address - Fax:814-774-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty