Cranberry Square Dermatology PC
Specialist in South Dennis, MA. Organization (NPI-2).
NPI number1982829495
StatusActive
Last updated in NPPESAug 28, 2014
Details
- NPI
- 1982829495
- Entity type
- Organization (NPI-2)
- Legal business name
- Cranberry Square Dermatology PC
- Organization subpart
- No
- Enumeration date
- Apr 17, 2007
- Last updated
- Aug 28, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 80792 | MA | Yes |
Practice location
434 Route 134Suite 1a
South Dennis, MA 02660-3433
Phone 508-394-5556 · Fax 508-394-2735
Mailing address
434 Route 134Suite 1a
South Dennis, MA 02660-3433
Phone 508-394-5556 · Fax 508-394-2735
Authorized official
Amy Beth Koff
Owner
5083945556
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