Provider Demographics
NPI:1235525114
Name:CLEVELAND DENTAL SLEEP THERAPY, LLC
Entity Type:Organization
Organization Name:CLEVELAND DENTAL SLEEP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-261-2580
Mailing Address - Street 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 520
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-2752
Mailing Address - Country:US
Mailing Address - Phone:216-261-2580
Mailing Address - Fax:
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-2752
Practice Address - Country:US
Practice Address - Phone:216-261-2580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.016099332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment