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General NPI Number Information
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NPI Number | 1326232489
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Entity Type | Organization
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Legal Business Name | DEAN VER MULM, OD PC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 804 BROADWAY ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-2422
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Country | US
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Telephone | 712-852-4123
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Fax | 712-852-4864
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Provider Business Mailing Address
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Address Line | 804 BROADWAY ST
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City | EMMETSBURG
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State | IA
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Zip | 50536-2422
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Country | US
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Telephone | 712-852-4123
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Fax | 712-852-4864
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEAN A. VER MULM
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Credential | O.D.
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Telephone | 712-852-4123
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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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