Individual
SHANNAN M DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
(419) 226-9826
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00396192
MEDICARE RR
OH
Enumeration date
06/06/2006
Last updated
05/16/2008
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