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General NPI Number Information
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NPI Number | 1962435420
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Entity Type | Organization
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Legal Business Name | DAYTON EYE ASSOCIATES INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 89 SYLVANIA DR
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City | DAYTON
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State | OH
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Zip | 45440-3237
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Country | US
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Telephone | 937-320-2020
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Fax | 937-320-0504
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Provider Business Mailing Address
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Address Line | 89 SYLVANIA DR
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City | DAYTON
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State | OH
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Zip | 45440-3237
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Country | US
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Telephone | 937-320-2020
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Fax | 937-320-0504
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | ANGIE PINTO
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Credential |
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Telephone | 937-320-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35040115
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License Number State | OH
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