Provider Demographics
NPI:1366881435
Name:PINNACLE OPTICAL
Entity type:Organization
Organization Name:PINNACLE OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-471-2020
Mailing Address - Street 1:2770 N. UNION BLVD.
Mailing Address - Street 2:SUITE 240
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1193
Mailing Address - Country:US
Mailing Address - Phone:719-471-3937
Mailing Address - Fax:
Practice Address - Street 1:2770 N. UNION BLVD.
Practice Address - Street 2:SUITE 240
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1193
Practice Address - Country:US
Practice Address - Phone:719-471-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier