Organization
DR DANIEL J DIETERICHS, OPTOMETRISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARBARA ANN DIETERICHS (PRACTICE MANAGER)
(505) 864-8992
Entity
Organization
Contact information
Practice address
837 W CASTILLO AVE, BELEN, NM 87002-3123
(505) 864-8992
(505) 864-8737
Mailing address
837 W CASTILLO AVE, BELEN, NM 87002-3123
(505) 864-8992
(505) 864-8737
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NM0P2390
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54384206
—
NM
Enumeration date
11/06/2007
Last updated
11/06/2007
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