Individual
DR. KEVIN P MISCHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1329 MAIN ST, WALPOLE, MA 02081
(508) 668-3970
(508) 668-2355
Mailing address
1329 MAIN ST, WALPOLE, MA 02081
(508) 668-3970
(508) 668-2355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19842
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0296953
MASSHEALTH
MA
Enumeration date
09/13/2006
Last updated
07/08/2007
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