Provider Demographics
NPI:1174763338
Name:MULLIN-KUCZMA, ANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:
Last Name:MULLIN-KUCZMA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1420
Mailing Address - Country:US
Mailing Address - Phone:617-792-8437
Mailing Address - Fax:
Practice Address - Street 1:223 ROUTE 3A
Practice Address - Street 2:SUITE 102
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025
Practice Address - Country:US
Practice Address - Phone:781-383-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry