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General NPI Number Information
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NPI Number | 1255408050
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Entity Type | Individual
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Provider Name | MICHAEL DENNIS ALLODOLI OD
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Gender | Male
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1991 SPROUL ROAD LAWRENCE PARK CENTER # 25
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City | BROOMALL
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State | PA
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Zip | 19008
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Country | US
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Telephone | 610-325-7688
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Fax | 610-325-7622
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Provider Business Mailing Address
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Address Line | 1991 SPROUL ROAD LAWRENCE PARK CENTER # 25
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City | BROOMALL
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State | PA
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Zip | 19008
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Country | US
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Telephone | 610-325-7688
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Fax | 610-325-7622
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG001600
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TO00385
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | I20001184
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License Number State | DE
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