Healthcare Provider Details

I. General information

NPI: 1548882525
Provider Name (Legal Business Name): DENTAL SLEEP CENTER OF CHAMBERSBURG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/15/2020
Certification Date: 05/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 LIMEKILN DR
CHAMBERSBURG PA
17201-4510
US

IV. Provider business mailing address

138 CHANCELLOR DR
CHAMBERSBURG PA
17201-3903
US

V. Phone/Fax

Practice location:
  • Phone: 717-491-3916
  • Fax:
Mailing address:
  • Phone: 717-491-3916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ANN DANIELS MILLER
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 717-491-3916