Provider Demographics
NPI:1679577464
Name:ROCHESTER, DENNIS ALLEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:ALLEN
Last Name:ROCHESTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9815 MAIN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2002
Mailing Address - Country:US
Mailing Address - Phone:301-253-4004
Mailing Address - Fax:301-253-3391
Practice Address - Street 1:9815 MAIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-2002
Practice Address - Country:US
Practice Address - Phone:301-253-4004
Practice Address - Fax:301-253-3391
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC00166363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant