Provider Demographics
NPI:1063979987
Name:VIZ DENTAL SLEEP SOLUTIONS
Entity type:Organization
Organization Name:VIZ DENTAL SLEEP SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:614-888-6811
Mailing Address - Street 1:660 COOPER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9394
Mailing Address - Country:US
Mailing Address - Phone:614-888-6811
Mailing Address - Fax:
Practice Address - Street 1:660 COOPER RD STE 200
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-9394
Practice Address - Country:US
Practice Address - Phone:614-888-6811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty