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Organization

SMART VISION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSILIN MAELIA QUINT O.D. (PRESIDENT/OPTOMETRIST)
(207) 622-5800
Entity
Organization

Contact information

Practice address
255 WESTERN AVE, AUGUSTA, ME 04330-4933
(207) 622-5800
(207) 621-2790
Mailing address
255 WESTERN AVE, AUGUSTA, ME 04330-4933
(207) 622-5800
(207) 621-2790

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT961
ME
332H00000X
Eyewear Supplier

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125420001
ME
05
125420100
ME
05
125420101
ME
Enumeration date
10/25/2006
Last updated
02/06/2017
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