Provider Demographics
NPI:1407419799
Name:SLEEP BETTER DENTAL MEDICINE OF THE MAIN LINE
Entity type:Organization
Organization Name:SLEEP BETTER DENTAL MEDICINE OF THE MAIN LINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOUMER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-234-3881
Mailing Address - Street 1:919 CONESTOGA RD
Mailing Address - Street 2:BUILDING ONE SUITE 100
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-234-3881
Mailing Address - Fax:610-525-3628
Practice Address - Street 1:919 CONESTOGA RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:610-234-3881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMY SHOUMER DMD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-22
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment