Provider Demographics
NPI:1194795088
Name:RORK, DENNIS G (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:G
Last Name:RORK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:6 BUTTRICK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0706670OtherAETNA USHC
NHB86216OtherHARVARD
NH0104902YPNH01OtherANTHEM BCBS
NH30001471Medicaid
NH404440OtherTUFTS
NH0102645OtherUNITED HEALTHCARE
NHNH9464Medicare ID - Type UnspecifiedMEDICARE