Provider Demographics
NPI:1679734636
Name:DOKKEN, SETH ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:ALAN
Last Name:DOKKEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 US 10 E
Mailing Address - Street 2:
Mailing Address - City:STAPLES
Mailing Address - State:MN
Mailing Address - Zip Code:56479-2371
Mailing Address - Country:US
Mailing Address - Phone:218-894-1331
Mailing Address - Fax:218-895-1332
Practice Address - Street 1:922 US 10 E
Practice Address - Street 2:
Practice Address - City:STAPLES
Practice Address - State:MN
Practice Address - Zip Code:56479-2371
Practice Address - Country:US
Practice Address - Phone:218-894-1331
Practice Address - Fax:218-895-1332
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3172152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist