Provider Demographics
NPI:1063787893
Name:DENTAL SLEEP SOLUTIONS PA
Entity type:Organization
Organization Name:DENTAL SLEEP SOLUTIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISFOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-261-2859
Mailing Address - Street 1:30 STATE ROUTE 18
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1420
Mailing Address - Country:US
Mailing Address - Phone:732-261-2859
Mailing Address - Fax:
Practice Address - Street 1:30 STATE ROUTE 18
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1420
Practice Address - Country:US
Practice Address - Phone:732-261-2859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI20783332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies