Organization
BDL MASS LLC
Active
Parent organization
BOSTON DERMATOLOGY AND LASER CENTER, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOSTON DERMATOLOGY AND LASER CENTER, LLC
Authorized official
SAMUEL GOOS (OWNER)
(978) 371-7010
Entity
Organization
Contact information
Practice address
54 BAKER AVENUE EXT, CONCORD, MA 01742-2137
(978) 371-7010
Mailing address
526 MAIN ST STE 302, ACTON, MA 01720-3301
(978) 371-7010
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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