Individual provider · NPI-1

Dr. Therese B Dahl, OD

Optometrist · Titusville, FL

NPI number1992878771
StatusActive
Last updated in NPPESFeb 4, 2009

Details

NPI
1992878771
Entity type
Individual (NPI-1)
Name
Dr. Therese B Dahl
Credential
OD
Sex
Female
Sole proprietor
No
Enumeration date
Nov 17, 2006
Last updated
Feb 4, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristOPL1525FLYes
152W00000X Optometrist1532WI

Practice location

3659 South Hopkins Ave
Suite D
Titusville, FL 32780

Phone 321-264-4264 · Fax 321-264-9433

Mailing address

3659 South Hopkins Ave
Suite D
Titusville, FL 32780

Phone 321-264-4264 · Fax 321-264-9433

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