Provider Demographics
NPI:1114915501
Name:MARION, DENNIS M (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:MARION
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 MIRA MESA BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4820
Mailing Address - Country:US
Mailing Address - Phone:858-578-2070
Mailing Address - Fax:858-578-2722
Practice Address - Street 1:9225 MIRA MESA BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4820
Practice Address - Country:US
Practice Address - Phone:858-578-2070
Practice Address - Fax:858-578-2722
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor