David P Collette, O.D.

Individual provider Active NPI Optometrist · South Burlington, VT

NPI 1477633006 · NPPES record last updated May 15, 2018

Key facts

NPI
1477633006
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
171 (VT)
Practice address
155 Dorset St
Pearle Vision Center University Mall
South Burlington, VT 05403-6346
Phone
(802) 658-4113
Fax
(802) 862-8945
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1504SCMDSchool Psychologist
171VTMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 171 VT Yes

Addresses

Primary practice location

155 Dorset St
Pearle Vision Center University Mall
South Burlington, VT 05403-6346

Mailing address

341 Palmetto Glen Dr
Myrtle Beach, SC 29588-6396
Phone (843) 742-1006

Other providers in South Burlington, VT

All providers in South Burlington, VT · Optometrist in Vermont

Sources for this page

Verify at the official NPI Registry.