Healthcare Provider Details

I. General information

NPI: 1003000621
Provider Name (Legal Business Name): DENNIS DULLANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BUFFALO ST SUITE B
FARMVILLE VA
23901-1112
US

IV. Provider business mailing address

1215 HERMITAGE RD #2418
RICHMOND VA
23220-1338
US

V. Phone/Fax

Practice location:
  • Phone: 434-315-5868
  • Fax: 434-736-9895
Mailing address:
  • Phone: 904-234-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556571
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: