Provider Demographics
NPI:1285657957
Name:O'BRIEN, WILLIAM JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 N PORT WASHINGTON RD
Mailing Address - Street 2:SUITE B262
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4503
Mailing Address - Country:US
Mailing Address - Phone:414-332-7450
Mailing Address - Fax:
Practice Address - Street 1:5900 N PORT WASHINGTON RD
Practice Address - Street 2:SUITE B262
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-4503
Practice Address - Country:US
Practice Address - Phone:414-332-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4279 - 151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics