Provider Demographics
NPI:1114738457
Name:RESTASSURED SLEEP CENTER
Entity type:Organization
Organization Name:RESTASSURED SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ETHEREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-627-9056
Mailing Address - Street 1:3365 BURNS RD STE 212
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4302
Mailing Address - Country:US
Mailing Address - Phone:561-627-9056
Mailing Address - Fax:561-625-0910
Practice Address - Street 1:3365 BURNS RD STE 212
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4302
Practice Address - Country:US
Practice Address - Phone:561-627-9056
Practice Address - Fax:561-625-0910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty