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General NPI Number Information
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NPI Number | 1003969288
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR SLEEP APNEA AND TMJ PA
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 1718 S. MILLENNIUM WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-1511
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Country | US
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Telephone | 208-376-3600
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Fax | 208-376-3616
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Provider Business Mailing Address
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Address Line | 1718 S. MILLENNIUM WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-1511
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Country | US
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Telephone | 208-376-3600
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Fax | 208-376-3616
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Authorized Official
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Title or Position | OWNER
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Name | CAMERON KUEHNE
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Credential | DMD, MS
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Telephone | 208-376-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D3199
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License Number State | ID
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