Individual
DR. ANISSA DERROUCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
529 MAIN ST STE 209, CHARLESTOWN, MA 02129-1135
(617) 241-9220
(617) 241-4905
Mailing address
529 MAIN ST STE 209, CHARLESTOWN, MA 02129-1135
(617) 241-9220
(617) 241-4905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20671
MA
Other
Enumeration date
05/16/2007
Last updated
10/01/2024
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