Provider Demographics
NPI:1215758230
Name:GAGE, DENNIS WARREN
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:WARREN
Last Name:GAGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8330 109TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:OSNABROCK
Mailing Address - State:ND
Mailing Address - Zip Code:58269-9617
Mailing Address - Country:US
Mailing Address - Phone:701-370-3796
Mailing Address - Fax:
Practice Address - Street 1:8330 109TH AVE NE
Practice Address - Street 2:
Practice Address - City:OSNABROCK
Practice Address - State:ND
Practice Address - Zip Code:58269-9617
Practice Address - Country:US
Practice Address - Phone:701-370-3796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant