Individual
KARL M DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2090 WOODWINDS DR, WOODBURY, MN 55125
(651) 968-5801
(651) 968-5899
Mailing address
PO BOX 86 SDS 12 2901, MINNEAPOLIS, MN 55486-2901
(651) 968-5050
(651) 968-5900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9979
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221054100
—
MN
Enumeration date
03/16/2006
Last updated
10/26/2009
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