MEDICARE: THOMAS D DENNIS OD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC813	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619398799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS D DENNIS OD LLC

Provider Business Mailing Address
First Line	:	1541 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6748
Country	:	US
Telephone Number	:	954-942-1313
Fax Number	:	954-942-0099

Provider Business Practice Location Address
First Line	:	1541 E ATLANTIC BLVD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6748
Country	:	US
Telephone Number	:	954-942-1313
Fax Number	:	954-942-0099

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. THOMAS D DENNIS
Credential	:	OD
Telephone Number	:	954-942-1313

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	08/22/2014

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Directions to “THOMAS D DENNIS OD LLC ” Practice Location

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