Healthcare Provider Details

I. General information

NPI: 1598162232
Provider Name (Legal Business Name): AZ SNORE NO MORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7757 W DEER VALLEY RD STE 260
PEORIA AZ
85382-2118
US

IV. Provider business mailing address

7757 W DEER VALLEY RD STE 260
PEORIA AZ
85382-2118
US

V. Phone/Fax

Practice location:
  • Phone: 602-284-5163
  • Fax:
Mailing address:
  • Phone: 602-284-5163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAY WRIGHT
Title or Position: OWNER
Credential: DDS
Phone: 602-284-5163