Provider Demographics
NPI:1538244025
Name:O'BRIEN, DANIEL PATRICK (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PATRICK
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 INMAN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-4511
Mailing Address - Country:US
Mailing Address - Phone:908-756-3388
Mailing Address - Fax:908-757-4466
Practice Address - Street 1:1163 INMAN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-4511
Practice Address - Country:US
Practice Address - Phone:908-756-3388
Practice Address - Fax:908-757-4466
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0173981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice