Provider Demographics
NPI:1265825426
Name:NAVARRO SLEEP AND SNORING SOLUTIONS LLC
Entity Type:Organization
Organization Name:NAVARRO SLEEP AND SNORING SOLUTIONS LLC
Other - Org Name:NAVARRO DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:EEDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-293-1097
Mailing Address - Street 1:1505 BOWIE CIR
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-1057
Mailing Address - Country:US
Mailing Address - Phone:214-293-1097
Mailing Address - Fax:903-872-5961
Practice Address - Street 1:1661 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-4107
Practice Address - Country:US
Practice Address - Phone:214-293-1097
Practice Address - Fax:903-872-5961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10586122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty