Provider Demographics
NPI:1518412279
Name:ANNAPOLIS SNORING AND SLEEP APNEA CENTER LLC
Entity Type:Organization
Organization Name:ANNAPOLIS SNORING AND SLEEP APNEA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLINA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-571-5138
Mailing Address - Street 1:200 WESTGATE CIR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3373
Mailing Address - Country:US
Mailing Address - Phone:410-571-5138
Mailing Address - Fax:443-458-5728
Practice Address - Street 1:200 WESTGATE CIR
Practice Address - Street 2:SUITE 106
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3373
Practice Address - Country:US
Practice Address - Phone:410-571-5138
Practice Address - Fax:443-458-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023871L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty