Healthcare Provider Details

I. General information

NPI: 1144995879
Provider Name (Legal Business Name): SLEEP BETTER SOUTHWEST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 04/04/2022
Certification Date: 04/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8841 E FLORENTINE RD STE E
PRESCOTT VALLEY AZ
86314-8776
US

IV. Provider business mailing address

8841 E FLORENTINE RD STE E
PRESCOTT VALLEY AZ
86314-8776
US

V. Phone/Fax

Practice location:
  • Phone: 928-778-4555
  • Fax: 928-220-8871
Mailing address:
  • Phone: 928-778-4555
  • Fax: 928-778-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JONATHAN HELD
Title or Position: DENTIST
Credential: DDS
Phone: 928-778-4555