Provider Demographics
NPI:1255737052
Name:DENTAL SLEEP MEDICINE CENTER LLC
Entity type:Organization
Organization Name:DENTAL SLEEP MEDICINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LON
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-933-3342
Mailing Address - Street 1:1150 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460
Mailing Address - Country:US
Mailing Address - Phone:610-933-3342
Mailing Address - Fax:
Practice Address - Street 1:1150 VALLEY FORGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:610-933-3342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025528L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty