Provider Demographics
NPI:1376974477
Name:O'BRIEN, MONIKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
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 1:468 HURFFVILLE CROSSKEYS RD
Mailing Address - Street 2:ATRIUM II, SUITE1
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2322
Mailing Address - Country:US
Mailing Address - Phone:856-553-6514
Mailing Address - Fax:856-553-6519
Practice Address - Street 1:468 HURFFVILLE CROSSKEYS RD
Practice Address - Street 2:ATRIUM II, SUITE1
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2322
Practice Address - Country:US
Practice Address - Phone:856-553-6514
Practice Address - Fax:856-553-6519
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-29
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO2279100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist