Organization
EYEDENTITY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE J CENTI O.D. (OWNER)
(410) 420-3933
Entity
Organization
Contact information
Practice address
223 BRIERHILL DR STE C, BEL AIR, MD 21015-4948
(410) 420-3933
(410) 420-6399
Mailing address
223 BRIERHILL DR STE C, BEL AIR, MD 21015-4948
(410) 420-3933
(410) 420-6399
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA 1449
MD
Other
Enumeration date
05/18/2010
Last updated
03/12/2014
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