Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 15605 | MA |
NPI | 1073718151 |
---|---|
Provider Name | Dr. Kenneth John Mcpartland |
First Address | Andover, MA 01810-6304 |
Second Address | Chelmsford, MA 01824-2738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |