Provider Demographics
NPI:1922582683
Name:SHORE SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:SHORE SLEEP SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-761-9700
Mailing Address - Street 1:273 ROUTE 34 STE 705
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-2438
Mailing Address - Country:US
Mailing Address - Phone:732-761-9700
Mailing Address - Fax:732-761-9771
Practice Address - Street 1:273 ROUTE 34 STE 705
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-2438
Practice Address - Country:US
Practice Address - Phone:732-761-9700
Practice Address - Fax:732-761-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty