Provider Demographics
NPI:1881942381
Name:DENTAL SLEEP ALTERNATIVES, LLC
Entity type:Organization
Organization Name:DENTAL SLEEP ALTERNATIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PONCZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, DABDSM
Authorized Official - Phone:866-903-0747
Mailing Address - Street 1:502 E STATE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2363
Mailing Address - Country:US
Mailing Address - Phone:866-903-0747
Mailing Address - Fax:866-910-6889
Practice Address - Street 1:502 E STATE ST
Practice Address - Street 2:SUITE B
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2363
Practice Address - Country:US
Practice Address - Phone:866-903-0747
Practice Address - Fax:866-910-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026404332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies