Provider Demographics
NPI:1720470164
Name:JOHN L BOUZIS
Entity Type:Organization
Organization Name:JOHN L BOUZIS
Other - Org Name:RESTFULSLEEP PLUS L.L.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOUZIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-265-3595
Mailing Address - Street 1:130 N ASH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1821
Mailing Address - Country:US
Mailing Address - Phone:307-265-3595
Mailing Address - Fax:
Practice Address - Street 1:130 N ASH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1821
Practice Address - Country:US
Practice Address - Phone:307-265-3595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY641122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty