Provider Demographics
NPI:1073521233
Name:OBRIEN, DANIEL N (DDS, MSD,)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:N
Last Name:OBRIEN
Suffix:
Gender:M
Credentials:DDS, MSD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S 38TH CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5749
Mailing Address - Country:US
Mailing Address - Phone:425-255-6008
Mailing Address - Fax:425-255-7625
Practice Address - Street 1:400 S 38TH CT
Practice Address - Street 2:SUITE A
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5749
Practice Address - Country:US
Practice Address - Phone:425-255-6008
Practice Address - Fax:425-255-7625
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000043851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry