Provider Demographics
NPI:1982204186
Name:DEKALB SLEEP SOLUTIONS LLC
Entity Type:Organization
Organization Name:DEKALB SLEEP SOLUTIONS LLC
Other - Org Name:DEKALB DENTAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-597-4798
Mailing Address - Street 1:201 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-1712
Mailing Address - Country:US
Mailing Address - Phone:615-597-4798
Mailing Address - Fax:
Practice Address - Street 1:201 S 3RD ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-1712
Practice Address - Country:US
Practice Address - Phone:615-597-4798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEKALB DENTAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-27
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies