Provider Demographics
NPI:1073714721
Name:DENNIS, ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0911
Mailing Address - Country:US
Mailing Address - Phone:207-303-3200
Mailing Address - Fax:
Practice Address - Street 1:51 US ROUTE 1 STE I
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7145
Practice Address - Country:US
Practice Address - Phone:207-303-3300
Practice Address - Fax:207-250-2139
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24444207R00000X
ME2067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433988399Medicaid