Healthcare Provider Details

I. General information

NPI: 1861491458
Provider Name (Legal Business Name): MICHAEL ROY DENNING DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9435 MOLLY PITCHER HWY
SHIPPENSBURG PA
17257-8527
US

IV. Provider business mailing address

9435 MOLLY PITCHER HWY
SHIPPENSBURG PA
17257-8527
US

V. Phone/Fax

Practice location:
  • Phone: 717-532-5811
  • Fax: 717-532-9004
Mailing address:
  • Phone: 717-532-5811
  • Fax: 717-532-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS023111L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: