Provider Demographics
NPI:1396113080
Name:SLEEP DISORDER DENTISTRY LLC
Entity type:Organization
Organization Name:SLEEP DISORDER DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTOL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-394-9587
Mailing Address - Street 1:15208 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4601
Mailing Address - Country:US
Mailing Address - Phone:636-394-6044
Mailing Address - Fax:
Practice Address - Street 1:1338 BIG BEND SQUARE SHOP CTR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-7618
Practice Address - Country:US
Practice Address - Phone:636-394-9587
Practice Address - Fax:636-394-9624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Single Specialty