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General NPI Number Information
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NPI Number | 1285937110
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Entity Type | Organization
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Legal Business Name | DAKOTA EYE CARE, P.C.
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 4001 2ND AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-2603
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Country | US
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Telephone | 701-577-2020
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Fax | 701-577-2021
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Provider Business Mailing Address
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Address Line | 4001 2ND AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-2603
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Country | US
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Telephone | 701-577-2020
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Fax | 701-577-2021
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. AMANDA M. LEE
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Credential | O.D.
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Telephone | 701-577-2020
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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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