Provider Demographics
NPI:1285019109
Name:DAYTON, CHELSEA (OD)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:DAYTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:ROOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:220 CHAMPION DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6665
Mailing Address - Country:US
Mailing Address - Phone:301-791-0888
Mailing Address - Fax:301-761-3611
Practice Address - Street 1:220 CHAMPION DR
Practice Address - Street 2:SUITE 100
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6665
Practice Address - Country:US
Practice Address - Phone:301-791-0888
Practice Address - Fax:301-761-3611
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2461152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist