Organization
AN OPTICAL GALLERIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT PINO (OWNER)
(443) 262-9415
Entity
Organization
Contact information
Practice address
111 W WATER ST, CENTREVILLE, MD 21617-1030
(443) 262-9415
(443) 262-9417
Mailing address
111 W WATER ST, CENTREVILLE, MD 21617-1030
(443) 262-9415
(443) 262-9417
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
17231525
MD
Other
Enumeration date
07/22/2006
Last updated
08/22/2020
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