Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DN1858644 | MA |
Y | 213EG0000X | General Practice | DN1858644 | MA |
NPI | 1003430067 |
---|---|
Provider Name | Dr. Dennis Kulka |
First Address | Hanover, MA 02339-1227 |
Second Address | Hanover, MA 02339-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2020 |
Last Update Date | 04/06/2020 |