Provider Demographics
NPI:1447457478
Name:O CONNELL, NANCY LAUREL (DDS)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LAUREL
Last Name:O CONNELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OLD PROS WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5670
Mailing Address - Country:US
Mailing Address - Phone:919-460-0177
Mailing Address - Fax:
Practice Address - Street 1:3803 COMPUTER DR # A
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6541
Practice Address - Country:US
Practice Address - Phone:919-781-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice