Provider Demographics
NPI:1558478644
Name:TOWN OF DENNIS
Entity Type:Organization
Organization Name:TOWN OF DENNIS
Other - Org Name:BOARD OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:TOWN ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-760-6118
Mailing Address - Street 1:685 ROUTE 134
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3056
Mailing Address - Country:US
Mailing Address - Phone:508-760-6158
Mailing Address - Fax:508-394-6289
Practice Address - Street 1:685 ROUTE 134
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3056
Practice Address - Country:US
Practice Address - Phone:508-760-6158
Practice Address - Fax:508-394-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY1111401Medicare PIN