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DR. JESSE VINCENT DOMINGUEZ O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1669789814

Individual Registrant:
DR. JESSE VINCENT DOMINGUEZ O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
725 E. MAIN ST. SUITE 1C SOMERTON, AZ 85350-0634 US
Tel: 928-627-4525  Fax: 928-627-4524

Contact information for business:
PO BOX 634  SOMERTON, AZ 85350-0634 US
Tel: 928-627-4525  Fax: 928-627-4524

Registration Information:
NPI: 1669789814
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
AZ1210

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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