Healthcare Provider Details

I. General information

NPI: 1932178134
Provider Name (Legal Business Name): DOVER VISION CENTRE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S DUPONT HWY
DOVER DE
19901
US

IV. Provider business mailing address

232 MITCHELL ST
MILLSBORO DE
19966-9412
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-3200
  • Fax: 302-678-5914
Mailing address:
  • Phone: 302-934-6620
  • Fax: 302-934-7386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: LYNN M MOORE
Title or Position: OPTICAL TECH BILLING COORDINATOR
Credential:
Phone: 302-934-6620