Provider Demographics
NPI:1073150058
Name:DENTAL SLEEP PROVIDERS, LLC
Entity Type:Organization
Organization Name:DENTAL SLEEP PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-646-5350
Mailing Address - Street 1:191 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-2392
Mailing Address - Country:US
Mailing Address - Phone:860-395-5200
Mailing Address - Fax:
Practice Address - Street 1:191 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2392
Practice Address - Country:US
Practice Address - Phone:860-395-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment