Provider Demographics
NPI:1760549869
Name:O'BRIEN, WILLIAM F
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-1189
Mailing Address - Country:US
Mailing Address - Phone:910-324-2084
Mailing Address - Fax:
Practice Address - Street 1:8207 RICHLANDS HIGHWAY
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28574
Practice Address - Country:US
Practice Address - Phone:910-324-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice