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Individual

DUSTIN J DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4337 S FLORIDA AVE, LAKELAND, FL 33813-1654
(863) 619-2700
Mailing address
407 AVENUE K SE, WINTER HAVEN, FL 33880-4126
(863) 294-3504
(863) 294-8305

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4781
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245578491
NPI
FL
Enumeration date
01/23/2013
Last updated
10/30/2019
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