Individual
DAVID MICHAEL KISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
80 WASHINGTON STREET B9, WASHINGTON SQUARE, NORWELL, MA 02061
(781) 871-8864
Mailing address
PO BOX 133, NORWELL, MA 02061
(781) 871-8864
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12290
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XO3801KI
BC BS MA
MA
Enumeration date
08/31/2006
Last updated
07/08/2007
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