Individual
DR. MARK ALAN DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
14 COMMUNITY PLZ, SULLIVAN, MO 63080-1567
(573) 468-2020
(636) 556-9952
Mailing address
PO BOX 280, SAINT CLAIR, MO 63077-0280
(573) 468-2020
(877) 428-6732
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2002015836
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315935700
—
MO
Enumeration date
11/02/2005
Last updated
08/07/2014
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