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General NPI Number Information
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NPI Number | 1427586080
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Entity Type | Organization
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Legal Business Name | DENISE M. KISSELL DDS, LLC
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 96 OLD BARNSTABLE RD
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City | MASHPEE
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State | MA
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Zip | 02649-3286
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Country | US
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Telephone | 508-477-0724
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 545
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City | MASHPEE
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State | MA
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Zip | 02649-0545
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Country | US
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Telephone | 508-477-0724
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DENISE MARIE KISSELL
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Credential | DDS
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Telephone | 508-447-0724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | MA
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