Provider Demographics
NPI:1568670701
Name:MCKENNA, DENNIS GARRETT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GARRETT
Last Name:MCKENNA
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-888-7575
Mailing Address - Fax:404-885-7777
Practice Address - Street 1:210 OAKSIDE LN
Practice Address - Street 2:SUITE C
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-6417
Practice Address - Country:US
Practice Address - Phone:678-593-1295
Practice Address - Fax:678-593-1294
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2013-11-15
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Provider Licenses
StateLicense IDTaxonomies
GA002070363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant