Provider Demographics
NPI:1447516661
Name:O'CONNOR, CHARIS MARIA (DMD)
Entity type:Individual
Prefix:
First Name:CHARIS
Middle Name:MARIA
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4113
Mailing Address - Country:US
Mailing Address - Phone:302-678-1440
Mailing Address - Fax:302-678-9984
Practice Address - Street 1:850 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4113
Practice Address - Country:US
Practice Address - Phone:302-678-1440
Practice Address - Fax:302-678-9984
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00013051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics