South Shore Skin Center, LLC
Specialist in Plymouth, MA. Organization (NPI-2).
NPI number1790763159
StatusActive
Last updated in NPPESJun 29, 2015
Details
- NPI
- 1790763159
- Entity type
- Organization (NPI-2)
- Legal business name
- South Shore Skin Center, LLC
- Organization subpart
- No
- Enumeration date
- Jan 5, 2006
- Last updated
- Jun 29, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
1 Scobee CirUnit 3
Plymouth, MA 02360-4887
Phone 508-747-0711 · Fax 508-746-9265
Mailing address
1 Scobee CirUnit 3
Plymouth, MA 02360-4887
Phone 508-747-0711 · Fax 508-746-9265
Authorized official
Richard F Eisen
Manager
5087470711
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