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General NPI Number Information
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NPI Number | 1316248743
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Entity Type | Organization
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Legal Business Name | DSS OPHTHALMIC DISPENSING PC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 875 BRIGHTON RD
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City | TONAWANDA
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State | NY
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Zip | 14150-8150
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Country | US
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Telephone | 716-832-0296
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Fax | 716-832-0943
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Provider Business Mailing Address
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Address Line | 875 BRIGHTON RD
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City | TONAWANDA
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State | NY
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Zip | 14150-8150
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Country | US
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Telephone | 716-832-0296
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Fax | 716-832-0943
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. DAVID S. SCHMIDT JR.
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Credential |
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Telephone | 716-832-0296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | C004982-1
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License Number State | NY
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