MEDICARE: DR. SKYLER LAGCHER O'BRIEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12407	NC

General Provider Information

NPI Number	:	1245811132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SKYLER LAGCHER O'BRIEN

Provider Business Mailing Address
First Line	:	2002 GROUPER RUN
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2327
Country	:	US
Telephone Number	:	919-903-0195
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 LIVE OAK ST
Second Line	:
City	:	BEAUFORT
State	:	NC
Zip	:	28516-1520
Country	:	US
Telephone Number	:	252-254-2738
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	04/06/2023

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