Healthcare Provider Details

I. General information

NPI: 1689072217
Provider Name (Legal Business Name): SLEEP TIGHT APPLIANCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2014
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 HIGH ST SUITE 201
DES MOINES IA
50309-3106
US

IV. Provider business mailing address

1540 HIGH ST SUITE 201
DES MOINES IA
50309-3106
US

V. Phone/Fax

Practice location:
  • Phone: 515-244-0329
  • Fax:
Mailing address:
  • Phone: 515-244-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number08102
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN JOSEPH BURDS
Title or Position: DENTIST/OWNER
Credential: D.D.S.
Phone: 515-244-0329