Individual
JACOB O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6020 S 3500 W STE A, ROY, UT 84067-9035
(801) 217-3359
Mailing address
6020 S 3500 W STE A, ROY, UT 84067-9035
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13996456-9925
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2022
Last updated
04/30/2025
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