Individual
KEVIN M O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 ROANOKE BLVD, SALEM, VA 24153-5032
(540) 389-0330
Mailing address
511 ROANOKE BLVD, SALEM, VA 24153-5032
(540) 389-0330
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414448
VA
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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