Provider Demographics
NPI:1902991490
Name:DENNING, DANIEL BRYON (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRYON
Last Name:DENNING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 LYNNFIELD STREET
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904
Mailing Address - Country:US
Mailing Address - Phone:781-477-0122
Mailing Address - Fax:508-587-0411
Practice Address - Street 1:340 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-588-3322
Practice Address - Fax:508-587-0411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2238111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1601008Medicaid
MAY45261Medicare UPIN