Provider Demographics
NPI:1801330865
Name:CENTER FOR DENTAL SLEEP HEALTH PA
Entity type:Organization
Organization Name:CENTER FOR DENTAL SLEEP HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:URA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-886-4300
Mailing Address - Street 1:74 NORTHEASTERN BLVD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3192
Mailing Address - Country:US
Mailing Address - Phone:603-886-4300
Mailing Address - Fax:603-886-5544
Practice Address - Street 1:74 NORTHEASTERN BLVD
Practice Address - Street 2:SUITE 19
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3192
Practice Address - Country:US
Practice Address - Phone:603-886-4300
Practice Address - Fax:603-886-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-10
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
NH2190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty