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General NPI Number Information
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NPI Number | 1407952583
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Entity Type | Organization
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Legal Business Name | ALLENTOWN VISION CENTER, PC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 740 W HAMILTON ST STE 100
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City | ALLENTOWN
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State | PA
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Zip | 18101-2425
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Country | US
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Telephone | 610-434-1000
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Fax | 610-434-9592
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Provider Business Mailing Address
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Address Line | 740 W HAMILTON ST STE 100
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City | ALLENTOWN
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State | PA
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Zip | 18101-2425
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Country | US
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Telephone | 610-434-1000
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Fax | 610-434-9592
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK JOSEPH DALTON
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Credential | O.D.
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Telephone | 610-434-1000
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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 | OEG00358
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License Number State | PA
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