Organization
TIMOTHY M. O'BRYAN DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY MICHAEL O'BRYAN DDS (MANAGER)
(573) 756-4344
Entity
Organization
Contact information
Practice address
12 E HARRISON ST, FARMINGTON, MO 63640-1859
(573) 756-4344
Mailing address
12 E HARRISON ST, FARMINGTON, MO 63640-1859
(573) 756-4344
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2006015354
MO
Other
Enumeration date
10/30/2008
Last updated
10/30/2008
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