Organization
FALLS OPTICAL, INC.
Active
Other names
Pierz Eyecare, St. Cloud Vision Clinic, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEN D DODGE OD (PRESIDENT)
(320) 224-5936
Entity
Organization
Contact information
Practice address
1850 1ST AVE NE, LITTLE FALLS, MN 56345-3381
(320) 632-2391
(320) 632-2392
Mailing address
1850 1ST AVE NE, LITTLE FALLS, MN 56345-3381
(320) 632-3291
(320) 632-2392
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2809
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173486
UNICARE
MN
01
—
2203387
MEDICA
MN
01
—
257J6CL
BCBS
MN
01
—
41-0049674
RAILROAD MEDICARE
MN
05
—
520042300
—
MN
Enumeration date
05/03/2007
Last updated
04/28/2022
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