Healthcare Provider Details

I. General information

NPI: 1396075024
Provider Name (Legal Business Name): GEORGE S. YATROS DENTAL SLEEP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 43RD ST W STE A
BRADENTON FL
34209-2953
US

IV. Provider business mailing address

402 43RD ST W STE A
BRADENTON FL
34209-2953
US

V. Phone/Fax

Practice location:
  • Phone: 941-757-4642
  • Fax: 844-868-4098
Mailing address:
  • Phone: 941-757-4642
  • Fax: 844-868-4098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE S YATROS
Title or Position: OWNER
Credential: D.M.D.
Phone: 941-757-4642