Healthcare Provider Details

I. General information

NPI: 1245092576
Provider Name (Legal Business Name): TOM G DELLINGER OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W CHURCH ST
CHERRYVILLE NC
28021-2805
US

IV. Provider business mailing address

PO BOX 160
CHERRYVILLE NC
28021-0160
US

V. Phone/Fax

Practice location:
  • Phone: 704-435-2020
  • Fax: 704-435-5267
Mailing address:
  • Phone: 704-435-2020
  • Fax: 704-435-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TOM GLENN DELLINGER
Title or Position: DIRECT OWNER
Credential: O.D.
Phone: 704-435-2020