Provider Demographics
NPI:1679314942
Name:O'HEARN, CAROLINE PATTON (DMD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:PATTON
Last Name:O'HEARN
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 1:1107 SPRING MARSH CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2422
Mailing Address - Country:US
Mailing Address - Phone:270-991-0502
Mailing Address - Fax:
Practice Address - Street 1:819 THOMPSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1774
Practice Address - Country:US
Practice Address - Phone:770-535-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist