Provider Demographics
NPI:1639308208
Name:DULLES TOWN CENTER OPTICS
Entity Type:Organization
Organization Name:DULLES TOWN CENTER OPTICS
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:UZUPIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-421-3359
Mailing Address - Street 1:21100 DULLES TOWN CIR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2437
Mailing Address - Country:US
Mailing Address - Phone:703-421-3359
Mailing Address - Fax:703-421-3428
Practice Address - Street 1:21100 DULLES TOWN CIR
Practice Address - Street 2:SUITE 290
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2437
Practice Address - Country:US
Practice Address - Phone:703-421-3359
Practice Address - Fax:703-421-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-05
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty