Individual
BRYAN PHILLIP COUSIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
205 WESTERN AVE, LYNN, MA 01904-2745
(781) 598-1180
Mailing address
205 WESTERN AVE, LYNN, MA 01904-2745
(781) 598-1180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14341
MA
Other
Enumeration date
08/21/2006
Last updated
02/03/2015
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