Provider Demographics
NPI:1376853705
Name:TWINKLESCAPE SLEEP DISORDERS CENTER-SMITHFIELD
Entity Type:Organization
Organization Name:TWINKLESCAPE SLEEP DISORDERS CENTER-SMITHFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-838-7600
Mailing Address - Street 1:1650 BOOKER DAIRY ROAD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9405
Mailing Address - Country:US
Mailing Address - Phone:919-838-7600
Mailing Address - Fax:919-838-7611
Practice Address - Street 1:9650 STRICKLAND ROAD
Practice Address - Street 2:SUITE 103-140
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1903
Practice Address - Country:US
Practice Address - Phone:919-838-7600
Practice Address - Fax:919-838-7611
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TWINKLESCAPE SLEEP DISORDERS CENTER PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic