Individual
GEORGIETTA R GDOVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
101 MONTGOMERY MALL, NORTH WALES, PA 19454
(215) 361-2400
(215) 361-0917
Mailing address
101 MONTGOMERY MALL, NORTH WALES, PA 19454-3903
(215) 361-2400
(215) 361-0917
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000359
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001954598 0008
—
PA
Enumeration date
09/06/2006
Last updated
08/22/2018
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