Provider Demographics
NPI:1992316251
Name:SLEEP BETTER IDAHO LLC
Entity type:Organization
Organization Name:SLEEP BETTER IDAHO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENYON
Authorized Official - Middle Name:L
Authorized Official - Last Name:OYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:208-412-1773
Mailing Address - Street 1:3200 N LESLIE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5362
Mailing Address - Country:US
Mailing Address - Phone:208-412-1773
Mailing Address - Fax:
Practice Address - Street 1:1246 YELLOWSTONE AVE STE B3
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-4372
Practice Address - Country:US
Practice Address - Phone:208-648-4908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty