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Organization

J AND D OPTICAL INC.

Active
Other names
Third Street Optical
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID R SMITH (VP FINANCE)
(218) 751-8313
Entity
Organization

Contact information

Practice address
212 3RD ST NW, BEMIDJI, MN 56601-3112
(218) 751-8313
(218) 444-3385
Mailing address
212 3RD ST NW, BEMIDJI, MN 56601-3112
(218) 751-8313
(218) 444-3385

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81410DU
BLUE CROSS
MN
05
926563500
MN
Enumeration date
07/03/2006
Last updated
05/15/2008
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