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Individual

DENNIS CHARLES SPANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 W GRANT ST, LAKE CITY, MN 55041-1143
(651) 345-3321
(651) 345-1151
Mailing address
1200 GRANT BLVD W, WABASHA, MN 55981-1042
(651) 565-5600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36426
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0113159
MEDICA
01
080125255
RAILROAD MEDICARE
01
118169
UCARE
01
49A86SP
BCBS
05
925515000
MN
01
MH9101008904
PREFERRED ONE
Enumeration date
12/15/2005
Last updated
10/01/2018
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