Healthcare Provider Details

I. General information

NPI: 1003536509
Provider Name (Legal Business Name): NORTH GEORGIA SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 RIVERBURCH PKWY
DALTON GA
30721-8676
US

IV. Provider business mailing address

1017 RIVERBURCH PKWY
DALTON GA
30721-8676
US

V. Phone/Fax

Practice location:
  • Phone: 706-529-7533
  • Fax:
Mailing address:
  • Phone: 706-529-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MURRELL STEPHEN TULL JR.
Title or Position: OWNER
Credential: DDS
Phone: 706-313-6378