Dahl, Therese B

Dahl, Therese B is an individual health care provider with primary practice located at 3659 South Hopkins Ave Suite D, Titusville FL 32780. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Dahl, Therese B can be contacted via phone (321) 264-4264.

Contact Information

Primary practice address
3659 South Hopkins Ave Suite D Titusville FL 32780
Phone: (321) 264-4264
Fax: (321) 264-9433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPL1525 Florida
Eye and Vision Services Providers / Optometrist 152W00000X 1532 Wisconsin

Profile Details

NPI number 1992878771
LBN Legal business name Dahl, Therese B
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Feb 4th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992878771 NPPES
Other 27596 AVESIS
MEDICAID 078593800 AVESIS
Other 114116 AVESIS
Other 1213330001 AVESIS
Other 180004904 AVESIS

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