Basic Information
| Provider Information | |||||||||
| NPI: | 1811229859 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DALE SCHELL OD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3759 E PHELPS ST | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852957226 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2501 S MARKET ST | ||||||||
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| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852951300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802246917 | ||||||||
| FaxNumber: | 4802246919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2010 | ||||||||
| LastUpdateDate: | 02/02/2010 | ||||||||
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| AuthorizedOfficialLastName: | SCHELL | ||||||||
| AuthorizedOfficialFirstName: | DALE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4803706914 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1368 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.