Organization
SHILOH OPTOMETRIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID MORRIS STINE O.D. (OWNER)
(937) 278-0675
Entity
Organization
Contact information
Practice address
5419 N MAIN ST, DAYTON, OH 45415-3454
(937) 278-0675
(937) 278-9535
Mailing address
5419 N MAIN ST, DAYTON, OH 45415-3454
(937) 278-0675
(937) 278-9535
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0645426
AETNA GROUP NUMBER
OH
05
—
2353859
—
OH
01
—
SH9329161
ANTHEM GROUP NUMBER
OH
Enumeration date
11/30/2006
Last updated
07/21/2022
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