Organization
MARK S DICKINSON OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S DICKINSON OD (PRESIDENT)
(404) 218-4912
Entity
Organization
Contact information
Practice address
13190 OWENS WAY, ALPHARETTA, GA 30004-7357
(404) 402-7870
(770) 872-7463
Mailing address
13190 OWENS WAY, ALPHARETTA, GA 30004-7357
(404) 402-7870
(770) 872-7463
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1046-T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000313046A
—
GA
05
—
000313046B
—
GA
Enumeration date
02/14/2007
Last updated
12/20/2017
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