Provider Demographics
NPI:1770869604
Name:VARGO, DENNIS LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LEONARD
Last Name:VARGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:108 FULTON ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-1422
Mailing Address - Country:US
Mailing Address - Phone:617-528-8988
Mailing Address - Fax:617-995-4827
Practice Address - Street 1:108 FULTON ST
Practice Address - Street 2:APARTMENT 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1422
Practice Address - Country:US
Practice Address - Phone:617-528-8988
Practice Address - Fax:617-995-4827
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01036936A207R00000X, 208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine