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General NPI Number Information
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NPI Number | 1912628900
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Entity Type | Organization
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Legal Business Name | EXPERTS ON SIGHT - MESA LLC
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 1919 E MCKELLIPS RD STE 103
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City | MESA
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State | AZ
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Zip | 85203-2855
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Country | US
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Telephone | 480-844-2286
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Fax | 480-610-6641
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Provider Business Mailing Address
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Address Line | 3303 S LINDSAY RD STE 101
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City | GILBERT
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State | AZ
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Zip | 85297-1504
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Country | US
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Telephone | 480-292-9835
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Fax | 480-292-9836
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Authorized Official
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Title or Position | CO-OWNER/OD
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Name | JODY DAGAN
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Credential | OD
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Telephone | 480-292-9835
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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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