Provider Demographics
NPI:1497905012
Name:DARE VISION CENTER O.D. P.A.
Entity Type:Organization
Organization Name:DARE VISION CENTER O.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JEPTHA
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-441-4872
Mailing Address - Street 1:PO BOX 1916
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-1916
Mailing Address - Country:US
Mailing Address - Phone:252-441-4872
Mailing Address - Fax:252-441-7812
Practice Address - Street 1:1004 S CROATAN HWY
Practice Address - Street 2:
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-8919
Practice Address - Country:US
Practice Address - Phone:252-441-4872
Practice Address - Fax:252-441-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC940152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty