Provider Demographics
NPI:1073968830
Name:HEALTHY SLEEP SOLUTION
Entity Type:Organization
Organization Name:HEALTHY SLEEP SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:PHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:951-246-8242
Mailing Address - Street 1:30141 ANTELOPE RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7001
Mailing Address - Country:US
Mailing Address - Phone:951-246-8242
Mailing Address - Fax:
Practice Address - Street 1:30141 ANTELOPE RD
Practice Address - Street 2:SUITE G
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-7001
Practice Address - Country:US
Practice Address - Phone:951-246-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46931332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies