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Organization

EBCON OPTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FREDERICK CHARLES BUENSUCESO O.D. (OPTOMETRIST)
(623) 980-5496
Entity
Organization

Contact information

Practice address
500 N ESTRELLA PKWY, GOODYEAR, AZ 85338-4135
(623) 980-5496
Mailing address
500 N ESTRELLA PKWY, GOODYEAR, AZ 85338-4135
(623) 980-5496

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1352
AZ

Other

Enumeration date
02/08/2011
Last updated
06/27/2011
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