Provider Demographics
NPI:1265204093
Name:DENTAL SLEEP CENTER - MEDFORD LLC
Entity type:Organization
Organization Name:DENTAL SLEEP CENTER - MEDFORD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-772-1215
Mailing Address - Street 1:1293 E MCANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6103
Mailing Address - Country:US
Mailing Address - Phone:154-177-2121
Mailing Address - Fax:
Practice Address - Street 1:1293 E MCANDREWS RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6103
Practice Address - Country:US
Practice Address - Phone:154-177-2121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment