Organization
JOHN B. CODJOE, D.D.S., P.C.
Active
Other names
Gateway Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN B CODJOE DDS (OWNER)
(508) 771-7751
Entity
Organization
Contact information
Practice address
269 BARNSTABLE ROAD, BARNSTABLE, MA 02601-3928
(508) 771-7751
(508) 827-4696
Mailing address
269 BARNSTABLE RD, HYANNIS, MA 02601-2917
(508) 771-7751
(508) 827-4696
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
DN1855757
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9903933
—
MA
Enumeration date
02/15/2007
Last updated
10/07/2011
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