Provider Demographics
NPI:1871786384
Name:O'LEAR, BRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:O'LEAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OLD FIELD RD
Mailing Address - Street 2:
Mailing Address - City:CENTERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11721-1726
Mailing Address - Country:US
Mailing Address - Phone:631-754-1988
Mailing Address - Fax:631-754-1992
Practice Address - Street 1:200 OLD FIELD RD
Practice Address - Street 2:
Practice Address - City:CENTERPORT
Practice Address - State:NY
Practice Address - Zip Code:11721-1726
Practice Address - Country:US
Practice Address - Phone:631-754-1988
Practice Address - Fax:631-754-1992
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037670-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist