Individual
COLLEEN O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-3000
Mailing address
612 ENGLEWOOD AVE, ROYAL OAK, MI 48073-2869
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1205562337
MI
122300000X
Dentist
2901601495
MI
Other
Enumeration date
07/29/2022
Last updated
11/15/2022
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