Individual
TIMOTHY A DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
224 N. 400 EAST, PANGUITCH, UT 84759
(435) 676-8842
(435) 676-2679
Mailing address
PO BOX 1096, PANGUITCH, UT 84759
(435) 676-8758
(435) 676-2679
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104445-1206
UT
Other
Enumeration date
07/14/2005
Last updated
07/08/2007
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