Provider Demographics
NPI:1598232019
Name:MICHAEL C. OBRIEN, DDS, PLLC
Entity Type:Organization
Organization Name:MICHAEL C. OBRIEN, DDS, PLLC
Other - Org Name:EMERGENT-DENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-995-3232
Mailing Address - Street 1:106 CUMULUS CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3513
Mailing Address - Country:US
Mailing Address - Phone:910-995-3232
Mailing Address - Fax:
Practice Address - Street 1:2401 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-2236
Practice Address - Country:US
Practice Address - Phone:919-833-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty