Provider Demographics
NPI:1780188433
Name:DENNIS, GRACE MARIA
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIA
Last Name:DENNIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HUDSON ST STE 211
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3115
Mailing Address - Country:US
Mailing Address - Phone:410-266-3305
Mailing Address - Fax:
Practice Address - Street 1:42 HUDSON ST STE 211
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3115
Practice Address - Country:US
Practice Address - Phone:410-266-3305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management