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General NPI Number Information
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NPI Number | 1346543295
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Entity Type | Organization
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Legal Business Name | DMS OPTICIANS INC
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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 | 26059 SOUTHFIELD RD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076-4526
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Country | US
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Telephone | 248-557-3212
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Fax | 248-557-3213
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Provider Business Mailing Address
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Address Line | 26059 SOUTHFIELD ROAD
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City | LATHRUP VILLAGE
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State | MI
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Zip | 48076
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Country | US
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Telephone | 248-557-3212
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Fax | 248-557-3213
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS DIANA SULLIVAN
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Credential |
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Telephone | 248-557-3212
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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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