Provider Demographics
NPI:1194214742
Name:NORWOOD DENTAL SLEEP MEDICINE LLC
Entity Type:Organization
Organization Name:NORWOOD DENTAL SLEEP MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WHITTIER
Authorized Official - Last Name:STODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-352-8497
Mailing Address - Street 1:100 DAY ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-2125
Mailing Address - Country:US
Mailing Address - Phone:781-352-8497
Mailing Address - Fax:781-352-8498
Practice Address - Street 1:100 DAY ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-2125
Practice Address - Country:US
Practice Address - Phone:781-352-8497
Practice Address - Fax:781-352-8498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16793261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service