Provider Demographics
NPI:1457497877
Name:DENNIS, MARGARET L (DMD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:L
Last Name:DENNIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 INWOOD TER
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5414
Mailing Address - Country:US
Mailing Address - Phone:904-536-1092
Mailing Address - Fax:
Practice Address - Street 1:4237 SALISBURY RD STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-0904
Practice Address - Country:US
Practice Address - Phone:904-296-1990
Practice Address - Fax:904-296-1989
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist