Provider Demographics
NPI:1649629593
Name:DEAN, EMILY MARIE (OD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:DEAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 POINT PLZ
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2572
Mailing Address - Country:US
Mailing Address - Phone:724-285-2618
Mailing Address - Fax:724-285-7507
Practice Address - Street 1:166 POINT PLZ
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2572
Practice Address - Country:US
Practice Address - Phone:724-285-2618
Practice Address - Fax:724-285-7507
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist