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General NPI Number Information
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NPI Number | 1164526455
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Entity Type | Organization
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Legal Business Name | DENTON OPTICAL COMPANY
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 523 BRYAN ST
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City | DENTON
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State | TX
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Zip | 76201-2705
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Country | US
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Telephone | 940-387-7115
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Fax |
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Provider Business Mailing Address
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Address Line | 523 BRYAN ST
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City | DENTON
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State | TX
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Zip | 76201-2705
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Country | US
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Telephone | 940-387-7115
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Fax |
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Authorized Official
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Title or Position | CERTIFIED MASTER OPTICIAN MANAGER
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Name | MR. HARVE KEITH BOYD III
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Credential | CERT MASTER OPTICIAN
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Telephone | 940-387-7115
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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 |
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License Number State |
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