Puetz, Daniel Gerard

Puetz, Daniel Gerard is an individual health care provider with primary practice located at 920 Brookwood Ctr , Fenton MO 63026-3474. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Puetz, Daniel Gerard can be contacted via phone (636) 343-8666.

Contact Information

Primary practice address
920 Brookwood Ctr Fenton MO 63026-3474
Phone: (636) 343-8666
Fax: (636) 326-1400
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X MO2530 Missouri

Profile Details

NPI number 1134214216
LBN Legal business name Puetz, Daniel Gerard
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134214216 NPPES
Missouri MEDICAID 311907109

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