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Organization

CENTRAL UTAH OPTICAL

Active
Other names
Excel Eye Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RON DUNN (ADMINISTRATOR)
(801) 374-1818
Entity
Organization

Contact information

Practice address
1735 N STATE ST, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959
Mailing address
1735 NORTH STATE STREET, PROVO, UT 84604-1010
(801) 374-1818
(801) 379-2959

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1284570001
CIGNA DMERC
UT
Enumeration date
10/05/2006
Last updated
03/15/2011
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