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General NPI Number Information
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NPI Number | 1710028519
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Entity Type | Organization
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Legal Business Name | C & S OPTOMETRIC SERVICES PLLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 2805 VILLAGE WAY
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City | NEW BERN
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State | NC
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Zip | 28562-7351
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Country | US
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Telephone | 252-633-0016
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Fax | 252-636-3895
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Provider Business Mailing Address
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Address Line | 2805 VILLAGE WAY
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City | NEW BERN
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State | NC
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Zip | 28562-7351
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Country | US
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Telephone | 252-633-0016
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Fax | 252-636-3895
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Authorized Official
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Title or Position | MANAGING CO-OWNER
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Name | DR. SHAWN A DOTY
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Credential | O.D.
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Telephone | 252-633-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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