Organization
DUNES OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY BAUSBACK O.D. (OPTOMETRIST)
(219) 878-5021
Entity
Organization
Contact information
Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 878-5021
(219) 878-5002
Mailing address
PO BOX L, MICHIGAN CITY, IN 46361-0310
(219) 878-5021
(219) 878-5002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200157480
—
IN
Enumeration date
09/20/2006
Last updated
07/01/2011
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