Healthcare Provider Details

I. General information

NPI: 1336097740
Provider Name (Legal Business Name): KANNLER DERMATOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 STILES RD STE 303
SALEM NH
03079-5802
US

IV. Provider business mailing address

29 STILES RD STE 303
SALEM NH
03079-5802
US

V. Phone/Fax

Practice location:
  • Phone: 603-290-2188
  • Fax:
Mailing address:
  • Phone: 603-290-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE KANNLER
Title or Position: PRESIDENT
Credential:
Phone: 603-290-2188