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General NPI Number Information
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NPI Number | 1033216163
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Entity Type | Individual
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Provider Name | ALAN D. DENNISON MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 110 MARTER AVE BLDG 500, SUITE 503
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3124
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Country | US
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Telephone | 856-608-8840
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Fax | 856-722-1898
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Provider Business Mailing Address
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Address Line | 110 MARTER AVE BLDG 500, SUITE 503
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3124
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Country | US
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Telephone | 856-608-8840
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Fax | 856-722-1898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA65290
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD066265L
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License Number State | PA
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