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General NPI Number Information
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NPI Number | 1215456512
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Entity Type | Individual
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Provider Name | KRISTEN MARIE O'BRIEN D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 348 BOSTON RD
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City | BILLERICA
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State | MA
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Zip | 01821-1812
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Country | US
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Telephone | 978-667-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 7 SHERWOOD RD
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City | WILMINGTON
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State | MA
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Zip | 01887-2817
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Country | US
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Telephone | 978-604-2987
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1857693
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License Number State | MA
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