Provider Demographics
NPI:1932493970
Name:NOSS, DENNIS BRIAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:BRIAN
Last Name:NOSS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:DENNY
Other - Middle Name:BRIAN
Other - Last Name:NOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:15 MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4403
Mailing Address - Country:US
Mailing Address - Phone:888-897-8880
Mailing Address - Fax:
Practice Address - Street 1:15 MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4403
Practice Address - Country:US
Practice Address - Phone:888-897-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2305213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine