Individual
ROBERTA DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-3501
Mailing address
195 CANAL ST, STE 210, MALDEN, MA 02148-6701
(781) 338-0500
(781) 338-0000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
270222
MA
390200000X
Student in an Organized Health Care Education/Training Program
260184
MA
Other
Enumeration date
06/05/2014
Last updated
08/08/2018
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