Provider Demographics
NPI:1407550700
Name:NORTHEAST DENTAL SLEEP THERAPY LLC
Entity Type:Organization
Organization Name:NORTHEAST DENTAL SLEEP THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-254-6385
Mailing Address - Street 1:79 EMPIRE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6019
Mailing Address - Country:US
Mailing Address - Phone:978-701-7755
Mailing Address - Fax:978-428-5354
Practice Address - Street 1:205 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-3194
Practice Address - Country:US
Practice Address - Phone:978-664-3141
Practice Address - Fax:978-664-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty