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General NPI Number Information
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NPI Number | 1285025858
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Entity Type | Organization
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Legal Business Name | DENNIS D GOLDEN OD
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 110 MAIN ST
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City | LOGANSPORT
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State | LA
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Zip | 71049-2996
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Country | US
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Telephone | 832-934-1166
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Fax | 832-934-1161
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Provider Business Mailing Address
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Address Line | 110 MAIN ST
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City | LOGANSPORT
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State | LA
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Zip | 71049-2996
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Country | US
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Telephone | 832-934-1166
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Fax | 832-934-1161
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Authorized Official
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Title or Position | OD/OWNER
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Name | DENNIS D. GOLDEN
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Credential | OD/OWNER
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Telephone | 832-934-1166
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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 |
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License Number State |
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