Organization Name: | SLEEP RIGHT DENTAL LLC |
NPI Number: | 1063848224 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN JOSEPH STOCK (OWNER) |
Mailing Address: | 4390 Green Ash Dr Earth City |
State: | MO US |
Postal Code: | 630451219 |
Phone Number: | 3145376815 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2013 |
NPI Last Update Date: | 09/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 2013017372 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |