Provider Demographics
NPI:1710520929
Name:SWEET DREAMS DENTAL ANESTHESIA LLC
Entity Type:Organization
Organization Name:SWEET DREAMS DENTAL ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-869-4700
Mailing Address - Street 1:5770 N HAMILTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3584
Mailing Address - Country:US
Mailing Address - Phone:614-869-4700
Mailing Address - Fax:614-869-4701
Practice Address - Street 1:5770 N HAMILTON RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-3584
Practice Address - Country:US
Practice Address - Phone:614-869-4700
Practice Address - Fax:614-869-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty