Dalton, Jeanine
Dalton, Jeanine is an individual health care provider with primary practice located at 230 N Lindbergh Blvd , Florissant MO 63031-5904. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Dalton, Jeanine can be contacted via phone (314) 921-9377.Contact Information
Primary practice address
230 N Lindbergh Blvd
Florissant MO 63031-5904
Phone: (314) 921-9377
Fax: (314) 830-2940
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T02920 | Missouri |
Profile Details
| NPI number | 1780680868 |
|---|---|
| LBN Legal business name | Dalton, Jeanine |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Oct 2nd, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780680868 | NPPES |
| Missouri | MEDICAID | 314895400 |
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