Individual
JOHN B CODJOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
269 BARNSTABLE RD, HYANNIS, MA 02601-2917
(508) 771-7751
(508) 827-4696
Mailing address
14 TABOR ROAD, FORESTDALE, MA 02644
(508) 771-7751
(508) 827-4696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855757
MA
1223G0001X
General Practice Dentistry
30.022311
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9903933
—
MA
Enumeration date
02/22/2007
Last updated
03/02/2012
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