Individual
DR. KELLY E OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
107 S 900 E, SALT LAKE CITY, UT 84102-4113
(801) 328-2803
(801) 328-2813
Mailing address
107 S 900 E, SALT LAKE CITY, UT 84102-4113
(801) 328-2803
(801) 328-2813
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
03755449922
UT
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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