Provider Demographics
NPI:1932637808
Name:DILLINGER, ERIC (OD, MS, BA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:DILLINGER
Suffix:
Gender:M
Credentials:OD, MS, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 HARVEST LN
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-4305
Mailing Address - Country:US
Mailing Address - Phone:507-451-3072
Mailing Address - Fax:507-451-4291
Practice Address - Street 1:2560 HARVEST LN
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-4305
Practice Address - Country:US
Practice Address - Phone:507-451-3072
Practice Address - Fax:507-451-4291
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3594152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist