Provider Demographics
NPI:1245691872
Name:SWEET DREAMS I LLC
Entity type:Organization
Organization Name:SWEET DREAMS I LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GREGG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-336-5711
Mailing Address - Street 1:1148 LOGAN SEWELL DR
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-3342
Mailing Address - Country:US
Mailing Address - Phone:318-336-5711
Mailing Address - Fax:318-336-5714
Practice Address - Street 1:1148 LOGAN SEWELL DR
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3342
Practice Address - Country:US
Practice Address - Phone:318-336-5711
Practice Address - Fax:318-336-5714
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM JARROD GREGG, DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5476332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment