Provider Demographics
NPI:1134683147
Name:SLEEP WELL DICKSON
Entity Type:Organization
Organization Name:SLEEP WELL DICKSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:GARLENE
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-740-7645
Mailing Address - Street 1:320 E COLLEGE ST STE A
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1893
Mailing Address - Country:US
Mailing Address - Phone:615-740-7645
Mailing Address - Fax:
Practice Address - Street 1:320 E COLLEGE ST STE A
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1893
Practice Address - Country:US
Practice Address - Phone:615-740-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCENT SMILE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty