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Organization

DEAN RETAIL SERVICES, INC.

Active
Other names
SSM Health Davis Duehr Dean Eye Care - Janesville
Organization subpart
No

Provider details

NPI number
Authorized official
AMY J GRINNELL (VICE PRESIDENT-FINANCE)
(608) 260-3586
Entity
Organization

Contact information

Practice address
3200 E RACINE ST, SUITE 200, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8834
Mailing address
3200 E RACINE ST, SUITE 200, JANESVILLE, WI 53546-2343
(608) 371-8000
(608) 371-8834

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
WI
332H00000X
Eyewear Supplier
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100048656
WI
Enumeration date
04/09/2007
Last updated
08/03/2020
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