| NPI | 1558762500 |
|---|---|
| Former Name | COLLEEN ELIZABETH O'NEILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02580800) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 36525) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2023-10-26 |