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General NPI Number Information
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NPI Number | 1497166912
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Entity Type | Organization
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Legal Business Name | O'BRIEN AND WEST DMD PLLC
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 2945 NEW BERN AVE
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City | RALEIGH
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State | NC
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Zip | 27610-1213
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Country | US
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Telephone | 919-783-5677
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MEARES BLUFF LN
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-4418
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Country | US
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Telephone | 407-383-2008
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PATRICK SEAN O'BRIEN
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Credential |
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Telephone | 407-383-2008
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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 | 8881
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License Number State | NC
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