Provider First Line Business Practice Location Address:
145 FAUNCE CORNER MALL ROAD
Provider Second Line Business Practice Location Address:
DERMATOLOGY SERVICES INC
Provider Business Practice Location Address City Name:
NO DARTMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-993-7601
Provider Business Practice Location Address Fax Number:
508-997-0523
Provider Enumeration Date:
03/19/2007