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General NPI Number Information
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NPI Number | 1619398799
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Entity Type | Organization
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Legal Business Name | THOMAS D DENNIS OD LLC
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 08/22/2014
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Provider Practice Location Address
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Address Line | 1541 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6748
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Country | US
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Telephone | 954-942-1313
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Fax | 954-942-0099
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Provider Business Mailing Address
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Address Line | 1541 E ATLANTIC BLVD
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6748
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Country | US
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Telephone | 954-942-1313
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Fax | 954-942-0099
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. THOMAS D DENNIS
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Credential | OD
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Telephone | 954-942-1313
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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 | OPC813
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License Number State | FL
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