Provider Demographics
NPI:1518424209
Name:WESTERN SLOPE SLEEP CENTER LLC
Entity Type:Organization
Organization Name:WESTERN SLOPE SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:DRAKULICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-514-4790
Mailing Address - Street 1:15460 6260 RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81403-6831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:747 S 5TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5712
Practice Address - Country:US
Practice Address - Phone:970-249-3157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL K. DRAKULICH, DDS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental