Provider Demographics
NPI:1316455835
Name:SERENITY SLEEP SOLUTIONS OF QUINCY, LLC
Entity type:Organization
Organization Name:SERENITY SLEEP SOLUTIONS OF QUINCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:STURHAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:217-257-0386
Mailing Address - Street 1:3800 E LAKE CTR STE 100
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-5839
Mailing Address - Country:US
Mailing Address - Phone:217-257-0386
Mailing Address - Fax:
Practice Address - Street 1:3800 E LAKE CTR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5839
Practice Address - Country:US
Practice Address - Phone:217-214-7222
Practice Address - Fax:217-403-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty