Provider Demographics
NPI:1588700520
Name:DENNISON, DAVID KEE (DDS, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KEE
Last Name:DENNISON
Suffix:
Gender:M
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 RICHMOND AVE
Mailing Address - Street 2:SUITE 509
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3019
Mailing Address - Country:US
Mailing Address - Phone:713-523-9040
Mailing Address - Fax:713-523-7885
Practice Address - Street 1:3100 RICHMOND AVE
Practice Address - Street 2:SUITE 509
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3019
Practice Address - Country:US
Practice Address - Phone:713-523-9040
Practice Address - Fax:713-523-7885
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147441223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760488193OtherTAX ID