Provider Demographics
NPI:1083182489
Name:O'BRIEN AND WEST DMD, VI, PLLC
Entity Type:Organization
Organization Name:O'BRIEN AND WEST DMD, VI, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-834-4932
Mailing Address - Street 1:2945 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1213
Mailing Address - Country:US
Mailing Address - Phone:919-834-4932
Mailing Address - Fax:
Practice Address - Street 1:10720 S TRYON ST STE H
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4572
Practice Address - Country:US
Practice Address - Phone:919-834-4932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty