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Individual

DENNIS P SKUTECKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
209 W JACKSON ST # 274, PHOENIX, AZ 85003-2406
(703) 651-6019
Mailing address
209 W JACKSON ST # 274, PHOENIX, AZ 85003-2406
(703) 651-6019

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
D02848687
AZ

Other

Enumeration date
04/29/2021
Last updated
04/29/2021
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