D & G Eye Associates, LLC
Optometrist in Edgewater, MD. Organization (NPI-2).
NPI number1982104105
StatusActive
Last updated in NPPESFeb 14, 2018
Details
- NPI
- 1982104105
- Entity type
- Organization (NPI-2)
- Legal business name
- D & G Eye Associates, LLC
- Organization subpart
- No
- Enumeration date
- Feb 14, 2018
- Last updated
- Feb 14, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | TA2312 | MD | Yes |
| 152WC0802X | Optometrist, Corneal and Contact Management | TA2312 | MD | |
| 152WP0200X | Optometrist, Pediatrics | TA2312 | MD |
Other names
- Tidewater Family Eye Care (Doing Business As)
Practice location
137 Mitchells Chance Rd Ste 120Edgewater, MD 21037-2793
Phone 410-956-2200
Mailing address
137 Mitchells Chance Rd Ste 120Edgewater, MD 21037-2793
Authorized official
Aidin Dean Gogerdchi
Owner
4105626636
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