Provider Demographics
NPI:1285025858
Name:DENNIS D GOLDEN OD
Entity Type:Organization
Organization Name:DENNIS D GOLDEN OD
Other - Org Name:GOLDEN EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:832-934-1166
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71049-2996
Mailing Address - Country:US
Mailing Address - Phone:832-934-1166
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:LA
Practice Address - Zip Code:71049-2996
Practice Address - Country:US
Practice Address - Phone:832-934-1166
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty