Provider Demographics
NPI:1285797597
Name:DAKIL, GEORGE T (OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:T
Last Name:DAKIL
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
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Mailing Address - Street 1:520 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5325
Mailing Address - Country:US
Mailing Address - Phone:918-251-6442
Mailing Address - Fax:918-251-6442
Practice Address - Street 1:520 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5325
Practice Address - Country:US
Practice Address - Phone:918-251-6442
Practice Address - Fax:918-251-6442
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK131654156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician