Provider Demographics
NPI:1831162098
Name:CLARE, DANIEL P (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:CLARE
Suffix:
Gender:M
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:PEARLE VISION
Mailing Address - Street 2:1056 BURNSVILLE CENTER
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-6301
Mailing Address - Country:US
Mailing Address - Phone:952-435-8821
Mailing Address - Fax:952-435-1624
Practice Address - Street 1:PEARLE VISION
Practice Address - Street 2:1056 BURNSVILLE CENTER
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-6301
Practice Address - Country:US
Practice Address - Phone:952-435-8821
Practice Address - Fax:952-435-1624
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2654152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6C439CLOtherBLUE CROSS BLUE SHIELD MN
MN918988OtherEYE MED / COLE VISION
MN290205200Medicaid
MN290205200Medicaid
MNH400334520Medicare PIN