Provider Demographics
NPI:1902216146
Name:DREAM VISION LLC
Entity Type:Organization
Organization Name:DREAM VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HA
Authorized Official - Middle Name:TIEN
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:617-265-0728
Mailing Address - Street 1:1461 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1338
Mailing Address - Country:US
Mailing Address - Phone:617-265-0728
Mailing Address - Fax:617-265-0931
Practice Address - Street 1:1461 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-1338
Practice Address - Country:US
Practice Address - Phone:617-265-0728
Practice Address - Fax:617-265-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty