Provider Demographics
NPI:1194882720
Name:DOLSEN, DENNIS (PA-C)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:DOLSEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2332
Practice Address - Country:US
Practice Address - Phone:717-765-5085
Practice Address - Fax:717-765-5066
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004665363AM0700X
PAMA057578363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103388951Medicaid
PA434562LN7Medicare PIN
VA1194882720Medicaid