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General NPI Number Information
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NPI Number | 1659195154
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Entity Type | Organization
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Legal Business Name | SANDY SPRINGS OPTICS LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 6631 ROSWELL RD STE G
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-3179
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Country | US
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Telephone | 404-303-6625
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 BRIDGE WALK DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5137
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Country | US
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Telephone | 770-655-0989
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | FAREED DOSANI
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Credential |
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Telephone | 770-655-0989
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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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