Provider Demographics
NPI:1255457297
Name:D&M OPTICAL AND HEARING CORP
Entity type:Organization
Organization Name:D&M OPTICAL AND HEARING CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GORAL
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:508-791-9291
Mailing Address - Street 1:551 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2018
Mailing Address - Country:US
Mailing Address - Phone:508-791-9291
Mailing Address - Fax:508-791-9292
Practice Address - Street 1:551 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2018
Practice Address - Country:US
Practice Address - Phone:508-791-9291
Practice Address - Fax:508-791-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5269156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty