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General NPI Number Information
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NPI Number | 1467434720
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Entity Type | Individual
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Provider Name | DANIEL A DENNIS III MD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 04/03/2019
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Provider Practice Location Address
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Address Line | 5 MOBILE INFIRMARY CIR
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City | MOBILE
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State | AL
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Zip | 36607-3513
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Country | US
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Telephone | 251-435-5114
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Fax |
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Provider Business Mailing Address
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Address Line | 50B MIDTOWN PARK W
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City | MOBILE
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State | AL
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Zip | 36606-4148
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Country | US
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Telephone | 251-435-5114
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 10944
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License Number State | AL
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