Provider Demographics
NPI:1295387298
Name:DASOD EYE CARE LLC
Entity Type:Organization
Organization Name:DASOD EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-789-6636
Mailing Address - Street 1:26772 POINT LOOKOUT RD
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-4905
Mailing Address - Country:US
Mailing Address - Phone:301-997-1822
Mailing Address - Fax:301-997-1949
Practice Address - Street 1:26772 POINT LOOKOUT RD
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-4905
Practice Address - Country:US
Practice Address - Phone:301-997-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DASOD EYE CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier