Provider Demographics
NPI:1083845051
Name:DA PONTE, DENNIS CARLOS (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CARLOS
Last Name:DA PONTE
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 1:4765 SPOTSWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:PENN LAIRD
Mailing Address - State:VA
Mailing Address - Zip Code:22846-2004
Mailing Address - Country:US
Mailing Address - Phone:540-432-5577
Mailing Address - Fax:866-662-7923
Practice Address - Street 1:4765 SPOTSWOOD TRL
Practice Address - Street 2:
Practice Address - City:PENN LAIRD
Practice Address - State:VA
Practice Address - Zip Code:22846-2004
Practice Address - Country:US
Practice Address - Phone:540-432-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor