Provider Demographics
NPI:1336613330
Name:DENTAL SLEEP PROVIDERS, LLC
Entity Type:Organization
Organization Name:DENTAL SLEEP PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:860-643-5350
Mailing Address - Street 1:945 MAIN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-6064
Mailing Address - Country:US
Mailing Address - Phone:860-643-5350
Mailing Address - Fax:860-646-5807
Practice Address - Street 1:945 MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6064
Practice Address - Country:US
Practice Address - Phone:860-643-5350
Practice Address - Fax:860-646-5807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty