Provider Demographics
NPI:1942787742
Name:HARMONY SLEEP MEDICINE FOR DENTISTRY LLC
Entity Type:Organization
Organization Name:HARMONY SLEEP MEDICINE FOR DENTISTRY LLC
Other - Org Name:HARMONY DENTISTRY FOR SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUNGAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-910-4830
Mailing Address - Street 1:1900 NE 162ND AVE STE D101
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-3015
Mailing Address - Country:US
Mailing Address - Phone:360-882-7866
Mailing Address - Fax:360-885-7756
Practice Address - Street 1:1900 NE 162ND AVE STE D101
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3015
Practice Address - Country:US
Practice Address - Phone:360-882-7866
Practice Address - Fax:360-885-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60014798332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies