Organization
DEAN RETAIL SERVICES, INC.
Active
Other names
SSM Health Davis Duehr Dean Eye Care-East
Organization subpart
No
Provider details
NPI number
Authorized official
AMY J GRINNELL (VICE PRESIDENT FINANCE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
1821 S STOUGHTON RD STE 200, MADISON, WI 53716-2257
(608) 260-6020
(608) 260-6181
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 294-6218
(608) 250-1384
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
WI
332H00000X
Eyewear Supplier
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942323795
—
WI
Enumeration date
04/09/2007
Last updated
08/03/2020
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