# JOHNATHON O'BRIEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487175634
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 09395 | IA | — |
| 1223G0001X | General Practice Dentistry | 101359-875 | WI | — |
| 1223G0001X | General Practice Dentistry | 7373 | NE | Yes |

## Other

- **Enumeration date:** 06/28/2017
- **Last updated:** 06/07/2024