Provider Demographics
NPI:1386667251
Name:DENNERY, MORICE P (MD)
Entity Type:Individual
Prefix:
First Name:MORICE
Middle Name:P
Last Name:DENNERY
Suffix:
Gender:M
Credentials:MD
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 2540
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2540
Mailing Address - Country:US
Mailing Address - Phone:603-356-5472
Mailing Address - Fax:603-356-2604
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5111
Practice Address - Country:US
Practice Address - Phone:603-356-5472
Practice Address - Fax:603-356-2604
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11621208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203647Medicaid
NHNH0022OtherANDROSCOGGIN VALLEY HOSPITAL
NHRE7915OtherAVH SURGICAL ASSOCIATES
NHRE6721Medicare ID - Type Unspecified
NHNH0022OtherANDROSCOGGIN VALLEY HOSPITAL