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General NPI Number Information
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NPI Number | 1598945438
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Entity Type | Organization
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Legal Business Name | DAPORE VISION CARE LLC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 1877 S MAPLE AVE SUITE 100
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City | FAIRBORN
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State | OH
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Zip | 45324-3460
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Country | US
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Telephone | 937-878-8800
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Fax | 937-878-8802
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Provider Business Mailing Address
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Address Line | 1877 S MAPLE AVE SUITE 100
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City | FAIRBORN
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State | OH
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Zip | 45324-3460
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Country | US
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Telephone | 937-878-8800
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Fax | 937-878-8802
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Authorized Official
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Title or Position | PARTNER
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Name | MS. SUZANNE L DAPORE
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Credential |
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Telephone | 937-878-8800
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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 | 3017
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License Number State | OH
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