Dr Bennett LLC

NPI #1164046967 in Fort Wayne, Indiana

Provider Information

NPI Number
1164046967
Entity Type
Organization
Organization Name
Dr Bennett LLC
Subpart
Yes (part of a larger organization)
Parent Organization
DR BENNETT LLC
Primary Specialty
Optometrist
Enumeration Date
Jun 8, 2020
Last Updated
Jun 17, 2020

Practice Location

Address
1850 E DUPONT RD
State
Indiana
ZIP Code
46825-1581
Phone
(260) 490-1060

Authorized Official

Name
DR. LANCE BENNETT, OD
Title
OPTOMETRIST
Phone
(260) 417-3467

Specialties & Taxonomy Codes

Specialty
Optometrist

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