Individual
DR. BRUCE FREDERICK DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 275-3325
Mailing address
8170 33RD AVE S, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
24496
WI
207Y00000X
Otolaryngology Physician
Primary
36789
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30475000
—
WI
05
—
561516000
—
MN
Enumeration date
12/07/2005
Last updated
03/15/2021
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