Provider Demographics
NPI:1659195154
Name:SANDY SPRINGS OPTICS LLC
Entity type:Organization
Organization Name:SANDY SPRINGS OPTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FAREED
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-655-0989
Mailing Address - Street 1:3466 BRIDGE WALK DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-5137
Mailing Address - Country:US
Mailing Address - Phone:770-655-0989
Mailing Address - Fax:
Practice Address - Street 1:6631 ROSWELL RD STE G
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3179
Practice Address - Country:US
Practice Address - Phone:404-303-6625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty