Provider Demographics
NPI:1437718772
Name:OLLOM DENTAL SLEEP CENTERS LLC
Entity Type:Organization
Organization Name:OLLOM DENTAL SLEEP CENTERS LLC
Other - Org Name:PURE SLEEP SOLUTIONZZZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:W
Authorized Official - Last Name:OLLOM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-228-4036
Mailing Address - Street 1:2115 ALLENTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-1749
Mailing Address - Country:US
Mailing Address - Phone:419-228-4036
Mailing Address - Fax:
Practice Address - Street 1:2115 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-1749
Practice Address - Country:US
Practice Address - Phone:419-228-4036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLLOM ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty