Provider Demographics
NPI:1326516006
Name:RENAISSANCE CENTER FOR SLEEP AND TMJ DISORDERS LLC
Entity Type:Organization
Organization Name:RENAISSANCE CENTER FOR SLEEP AND TMJ DISORDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIANNI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-462-9888
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-0190
Mailing Address - Country:US
Mailing Address - Phone:732-462-9888
Mailing Address - Fax:
Practice Address - Street 1:16222 N 59TH AVE STE D170
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-1708
Practice Address - Country:US
Practice Address - Phone:732-462-9888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental