Provider Demographics
NPI:1750936720
Name:DENNINGTON COLLAB
Entity type:Organization
Organization Name:DENNINGTON COLLAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLYNN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-698-6393
Mailing Address - Street 1:9091 FAIR OAKS PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4690
Mailing Address - Country:US
Mailing Address - Phone:210-698-6393
Mailing Address - Fax:210-698-9788
Practice Address - Street 1:9091 FAIR OAKS PKWY STE 307
Practice Address - Street 2:
Practice Address - City:FAIR OAKS RANCH
Practice Address - State:TX
Practice Address - Zip Code:78015-4690
Practice Address - Country:US
Practice Address - Phone:210-698-6393
Practice Address - Fax:210-698-9788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty