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General NPI Number Information
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NPI Number | 1316067960
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Entity Type | Organization
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Legal Business Name | DAWN MACCREERY OD
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3050 E LAKE LANSING RD SUITE C
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-332-1011
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Fax | 517-332-6321
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Provider Business Mailing Address
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Address Line | 3050 E LAKE LANSING RD SUITE C
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City | EAST LANSING
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State | MI
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Zip | 48823
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Country | US
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Telephone | 517-332-1011
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Fax | 517-332-6321
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DAWN YVONNE MACCREERY
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Credential | OD
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Telephone | 517-332-1011
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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 | 4901002817
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License Number State | MI
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