Individual
JON E DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH, FAAP
Contact information
Practice address
1900 CENTRACARE CIR, SUITE #1300, SAINT CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Mailing address
1900 CENTRACARE CIR, SUITE #1300, SAINT CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24057
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110408
U CARE
—
01
—
1123622
FIRST HEALTH PLAN
—
01
—
1202199
MEDICA HEALTH PLANS
—
01
—
254009
PREFERRED ONE
—
01
—
51A32DE
BLUE CROSS BLUE SHIELD
—
01
—
556146
ARAZ GROUP AMERICAS PPO
—
01
—
HP25415
HEALTH PARTNERS
—
01
—
SHP50A90DE
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/28/2005
Last updated
07/08/2007
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