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NPI Code Detail

MEDICARE: O'BRIEN AND WEST, DMD IV, PLLC

MEDICARE: O'BRIEN AND WEST, DMD IV, PLLC
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
11223G0001XGeneral Practice Dentistry8793NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760918684
Entity Type Code : Organization
Provider Name (Legal Business Name) : O'BRIEN AND WEST, DMD IV, PLLC
Provider Business Mailing Address
First Line : 6316 E INDEPENDENCE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-6953
Country : US
Telephone Number : 919-834-4932
Fax Number :
Provider Business Practice Location Address
First Line : 6316 E INDEPENDENCE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-6953
Country : US
Telephone Number : 919-834-4932
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : KATHLEEN SALTAMARTINI
Credential :
Telephone Number : 919-845-6450
Provider Enumeration Date : 05/11/2017
Last Update Date : 05/11/2017

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