Provider Demographics
NPI:1225292840
Name:O'BRIEN, ALLISON L (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:L
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8936 77TH TER E UNIT 103
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6419
Mailing Address - Country:US
Mailing Address - Phone:941-373-3904
Mailing Address - Fax:941-907-0565
Practice Address - Street 1:8936 77TH TER E UNIT 103
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6419
Practice Address - Country:US
Practice Address - Phone:941-373-3904
Practice Address - Fax:941-907-0565
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL185361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice