Provider Demographics
NPI:1538645809
Name:OBRIEN, SARA MARIE (DMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:OBRIEN
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 1:10 OLD MILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-6738
Mailing Address - Country:US
Mailing Address - Phone:724-503-4435
Mailing Address - Fax:724-470-9937
Practice Address - Street 1:6201 STEUBENVILLE PIKE STE 110
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1389
Practice Address - Country:US
Practice Address - Phone:412-722-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041856122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist