Provider Demographics
NPI:1285790386
Name:O'BRIEN, ACHARA D (DDS)
Entity type:Individual
Prefix:DR
First Name:ACHARA
Middle Name:D
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 IRON GATE DR
Mailing Address - Street 2:STE 204
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6625
Mailing Address - Country:US
Mailing Address - Phone:910-798-1588
Mailing Address - Fax:
Practice Address - Street 1:2601 IRON GATE DR
Practice Address - Street 2:STE 204
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6625
Practice Address - Country:US
Practice Address - Phone:910-798-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics