Provider Demographics
NPI:1356831630
Name:DENNIS, MARGEAUX JENEE (DO)
Entity type:Individual
Prefix:
First Name:MARGEAUX
Middle Name:JENEE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746643
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6643
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:1348 S 18TH ST STE 230
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-4785
Practice Address - Country:US
Practice Address - Phone:904-277-2003
Practice Address - Fax:904-277-2006
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2024-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS21391208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology