Provider Demographics
NPI:1467970772
Name:SLEEP BETTER WYOMING LLC
Entity Type:Organization
Organization Name:SLEEP BETTER WYOMING LLC
Other - Org Name:SLEEP BETTER WYOMING LLC BRYANT P BIRCH DDS PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:P
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:307-871-6832
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-0309
Mailing Address - Country:US
Mailing Address - Phone:307-875-3658
Mailing Address - Fax:307-875-3660
Practice Address - Street 1:661 UINTA DR
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5056
Practice Address - Country:US
Practice Address - Phone:307-875-3658
Practice Address - Fax:307-875-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1149261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental