# O'BRIEN AND O'BRIEN DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497978290
- **Authorized official:** BRENDA SALADIN (DENTAL INSURANCE SPECIALIST)
- **Authorized official phone:** (616) 361-2617

## Contact information

- **Practice address:** 1503 COIT AVE NE, GRAND RAPIDS, MI 49505-4906
- **Practice address phone:** (616) 361-2617
- **Practice address fax:** (616) 361-2390
- **Mailing address:** 1503 COIT AVE NE, GRAND RAPIDS, MI 49505-4906
- **Mailing address phone:** (616) 361-2617
- **Mailing address fax:** (616) 361-2390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 11606 | MI | — |
| 1223G0001X | General Practice Dentistry | 11607 | MI | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 11606 | STATE ID NUMBER | MI |
| 01 | — | 11607 | STATE ID NUMBER | MI |
| 05 | — | 4051278 | — | MI |
| 05 | — | 4051287 | — | MI |