MEDICARE: STEVEN MICHAEL DENNIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4433	AZ

General Provider Information

NPI Number	:	1235265554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN MICHAEL DENNIS DC

Provider Business Mailing Address
First Line	:	3602 W BETHANY HOME RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85019-1942
Country	:	US
Telephone Number	:	602-943-4131
Fax Number	:	602-973-8281

Provider Business Practice Location Address
First Line	:	3602 W BETHANY HOME RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85019-1942
Country	:	US
Telephone Number	:	602-943-4131
Fax Number	:	602-973-8281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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