Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DE00004385 | WA |
NPI | 1073521233 |
---|---|
Provider Name | Dr. Daniel N. Obrien |
First Address | Renton, WA 98055-5749 |
Second Address | Renton, WA 98055-5749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |