Organization
DALE RODRIGUE EYECARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE L RODRIGUE O.D (OWNER)
(207) 623-5099
Entity
Organization
Contact information
Practice address
58 STATE ST, AUGUSTA, ME 04330-5124
(207) 623-5099
(207) 623-7124
Mailing address
58 STATE ST, AUGUSTA, ME 04330-5124
(207) 623-5099
(207) 623-7124
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT690
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114510000
—
ME
Enumeration date
06/30/2011
Last updated
07/08/2015
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