Provider Demographics
NPI:1437524824
Name:CENTRAL MASS SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:CENTRAL MASS SLEEP SOLUTIONS LLC
Other - Org Name:JOHN J MILLETTE DMD PC SOLE MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-887-3896
Mailing Address - Street 1:119 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01524-1403
Mailing Address - Country:US
Mailing Address - Phone:508-892-9417
Mailing Address - Fax:508-892-4279
Practice Address - Street 1:119 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:MA
Practice Address - Zip Code:01524-1403
Practice Address - Country:US
Practice Address - Phone:508-892-4882
Practice Address - Fax:508-892-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17984122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty