Provider Demographics
NPI:1568076701
Name:ALTERNATIVE SLEEP SOLUTION
Entity Type:Organization
Organization Name:ALTERNATIVE SLEEP SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BLAICH
Authorized Official - Suffix:IV
Authorized Official - Credentials:DMD
Authorized Official - Phone:573-785-0111
Mailing Address - Street 1:2700 KANELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901
Mailing Address - Country:US
Mailing Address - Phone:573-712-8966
Mailing Address - Fax:573-785-3840
Practice Address - Street 1:2700 KANELL BLVD.
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901
Practice Address - Country:US
Practice Address - Phone:573-712-8966
Practice Address - Fax:573-785-3840
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL ARTS GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty