Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | AN 1992975J106 | MA |
Y | 208600000X | Surgeon | AN 1992975J106 | MA |
NPI | 1013170497 |
---|---|
Provider Name | Dr. Julian Dachille |
First Address | Hyannis, MA 02601-5133 |
Second Address | Mashpee, MA 02649-2652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 29/05/2020 |