Individual
MR. JOHN MATTHEW DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAS REG.
Contact information
Practice address
2914A COLD SPRINGS RD, PLACERVILLE, CA 95667-4220
(530) 642-1715
(530) 642-2064
Mailing address
PO BOX 221, SHINGLE SPRINGS, CA 95682-0221
(530) 677-8029
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1838 REG.
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1838 REG.
CAS REG.
CA
Enumeration date
03/16/2007
Last updated
07/08/2007
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