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General NPI Number Information
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NPI Number | 1730250226
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Entity Type | Organization
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Legal Business Name | MAIN PLACE OPTICAL INC.
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 390 MAIN ST # 350 MAIN PLACE MALL
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City | BUFFALO
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State | NY
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Zip | 14202-3702
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Country | US
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Telephone | 716-852-7572
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Fax | 716-854-0954
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Provider Business Mailing Address
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Address Line | 390 -350 MAIN ST MAIN PLACE MALL
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City | BUFFALO
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State | NY
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Zip | 14202-3750
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Country | US
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Telephone | 716-852-7572
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Fax | 716-854-0954
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DENNIS OSIAK
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Credential |
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Telephone | 716-852-7572
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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 | VUT005065
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License Number State | NY
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