Healthcare Provider Details
I. General information
NPI: 1053360107
Provider Name (Legal Business Name): ADVANCED EYE SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2006
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 FAUNCE CORNER RD SUITE 180
N DARTMOUTH MA
02747-1278
US
IV. Provider business mailing address
500 FAUNCE CORNER RD SUITE 180
NORTH DARTMOUTH MA
02747-1278
US
V. Phone/Fax
- Phone: 508-717-0270
- Fax: 508-995-3060
- Phone: 508-717-0270
- Fax: 508-995-3060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PAUL
C
ABRANTES
Title or Position: ADMINISTRATOR
Credential:
Phone: 508-717-0266