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General NPI Number Information
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NPI Number | 1740925569
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Entity Type | Organization
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Legal Business Name | DEI OPTICAL COMPANY
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 200 S 5TH ST
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City | BISMARCK
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State | ND
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Zip | 58504-5675
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Country | US
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Telephone | 701-222-3937
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Fax | 701-222-2880
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Provider Business Mailing Address
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Address Line | 200 S 5TH ST
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City | BISMARCK
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State | ND
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Zip | 58504-5675
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Country | US
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Telephone | 701-222-3937
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Fax | 701-222-2880
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Authorized Official
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Title or Position | CEO
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Name | ALEESA BRORBY
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Credential |
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Telephone | 701-557-7278
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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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