Organization
SUNDANCE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP K CLARK LDO (OWNER)
(602) 277-5007
Entity
Organization
Contact information
Practice address
4201 N 16TH ST, STE 160, PHOENIX, AZ 85016-5347
(602) 277-5007
(602) 279-0557
Mailing address
4201 N 16TH ST STE 160, PHOENIX, AZ 85016-5348
(602) 277-5007
(602) 279-0557
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
417
AZ
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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