Organization Name:  DEDHAM MEDICAL ASSOC INC


Practice Location:
1 LYONS ST  DEDHAM, MA 02026 US
Tel: 781-329-1400  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	MA	=========

Other Provider Identifiers:

Issuer	Number	State	Type
	9766545	MA	05
	9766561	MA	05
	9766529	MA	05
	9766626	MA	05
	9766634	MA	05
	9766588	MA	05
	9766618	MA	05
	9766553	MA	05
	9766537	MA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin