Provider Demographics
NPI:1770912537
Name:BAY AREA DENTAL SLEEP ASSOCIATES
Entity type:Organization
Organization Name:BAY AREA DENTAL SLEEP ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRIOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-791-0139
Mailing Address - Street 1:2467 ENTERPRISE RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1724
Mailing Address - Country:US
Mailing Address - Phone:727-791-0139
Mailing Address - Fax:
Practice Address - Street 1:2467 ENTERPRISE RD
Practice Address - Street 2:SUITE F
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1724
Practice Address - Country:US
Practice Address - Phone:727-791-0139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBN15893122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty