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General NPI Number Information
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NPI Number | 1124456520
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Entity Type | Organization
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Legal Business Name | DAVID P BUCUREL OD INC
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Dates
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Enumeration Date | 10/22/2013
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 9354 MENTOR AVE STE 6
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City | MENTOR
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State | OH
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Zip | 44060-6467
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Country | US
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Telephone | 440-255-1929
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Fax |
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Provider Business Mailing Address
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Address Line | 9354 MENTOR AVE STE 6
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City | MENTOR
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State | OH
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Zip | 44060-6467
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Country | US
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Telephone | 440-255-1929
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID P BUCUREL
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Credential | D.O
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Telephone | 440-255-1929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 3332T1180
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License Number State | OH
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