Provider Demographics
NPI:1346477320
Name:DANCE, DONNIE D (OD)
Entity Type:Individual
Prefix:MR
First Name:DONNIE
Middle Name:D
Last Name:DANCE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:3535 APALACHEE PKWY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-5330
Mailing Address - Country:US
Mailing Address - Phone:850-219-0788
Mailing Address - Fax:850-878-6138
Practice Address - Street 1:3535 APALACHEE PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-5330
Practice Address - Country:US
Practice Address - Phone:850-219-0788
Practice Address - Fax:850-878-6138
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC882152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC882OtherFL LICENSE