| O'brien and O'brien DDS PC | |
|
1503 Coit Ave Ne Grand Rapids MI 49505-4906 | |
| (616) 361-2617 | |
| (616) 361-2390 |
| Full Name | O'brien and O'brien DDS PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1503 Coit Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Brenda Saladin (DENTAL INSURANCE SPECIALIST) |
| Authorized Official Contact | 6163612617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| O'brien and O'brien DDS PC 1503 Coit Ave Ne Grand Rapids MI 49505-4906 Ph: (616) 361-2617 | O'brien and O'brien DDS PC 1503 Coit Ave Ne Grand Rapids MI 49505-4906 Ph: (616) 361-2617 |
| NPI Number | 1497978290 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497978290 | NPI | - | NPPES |
| 11606 | Other | MI | STATE ID NUMBER |
| 4051278 | Medicaid | MI | |
| 4051287 | Medicaid | MI | |
| 11607 | Other | MI | STATE ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11607 (Michigan) | Primary |
| 1223G0001X | Dentist - General Practice | 11606 (Michigan) | Secondary |
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