Provider Demographics
NPI:1881012250
Name:DENT EYE CENTER LLC
Entity Type:Organization
Organization Name:DENT EYE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DENT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:636-578-0067
Mailing Address - Street 1:PO BOX 1095
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-1095
Mailing Address - Country:US
Mailing Address - Phone:660-665-5674
Mailing Address - Fax:
Practice Address - Street 1:2121 N BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-5110
Practice Address - Country:US
Practice Address - Phone:660-665-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001556207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty