Healthcare Provider Details

I. General information

NPI: 1265289649
Provider Name (Legal Business Name): DLS VISION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3264 BUFORD DR STE 100A
BUFORD GA
30519-8743
US

IV. Provider business mailing address

3466 BRIDGE WALK DR
LAWRENCEVILLE GA
30044-5137
US

V. Phone/Fax

Practice location:
  • Phone: 678-395-2020
  • Fax:
Mailing address:
  • Phone: 770-655-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. FAREED DOSANI
Title or Position: OWNER
Credential: OD
Phone: 770-655-0989