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General NPI Number Information
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NPI Number | 1891582334
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Entity Type | Individual
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Provider Name | PRINCE A DENSON V OD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 15301 WARREN SHINGLE RD
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City | BEALE AFB
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State | CA
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Zip | 95903-1905
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Country | US
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Telephone | 530-634-2941
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Fax | 530-634-4763
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Provider Business Mailing Address
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Address Line | 15301 WARREN SHINGLE RD
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City | BEALE AFB
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State | CA
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Zip | 95903-1905
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Country | US
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Telephone | 530-634-2941
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Fax | 530-634-4713
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT.0004146
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License Number State | CO
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