Jesse Vincent Dominguez O.D.

NPI 1669789814 - Optometrist - 152W00000X

NPI Details
NPI 1669789814
Gender Male
Enumeration Date 09/09/2010
Last Updated 08/14/2013
Entity Type Individual
Active Over 6 years ago
Practice Location
725 E. MAIN ST.
SUITE 1C
SOMERTON AZ, 85350-0634, US
Phone (928) 627-4525
Fax (928) 627-4524
Business Location
PO BOX 634
SOMERTON AZ, 85350-0634, US
Phone (928) 627-4525
Fax (928) 627-4524
Toxanomy
Taxonomy Code 152W00000X
License State Arizona
License Number 1210
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According to our database, Dr. Jesse Vincent Dominguez O.D. NPI is 1669789814, taxonomy code is 152W00000X and license number is 1210, license state is located at Arizona. Jesse Vincent Dominguez O.D. physically located at 725 E. Main St., Somerton AZ, 85350-0634. NPI Number Jesse Vincent Dominguez O.D. has the Individual type.

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1669789814 NPI number is provided on an as is basis without warranty of any kind. 1669789814 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse Vincent Dominguez O.D. are for informational purposes only.