Organization
BARON T. DENNISTON M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARON T. DENNISTON M.D. (PHYSICAN)
(814) 456-1863
Entity
Organization
Contact information
Practice address
150 E 8TH ST, ERIE, PA 16501-1269
(814) 456-1863
Mailing address
150 E 8TH ST, ERIE, PA 16501-1269
(814) 456-1863
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
MD044333L
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1249105
—
PA
Enumeration date
10/07/2008
Last updated
10/07/2008
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