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General NPI Number Information
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NPI Number | 1104225952
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Entity Type | Organization
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Legal Business Name | COLORADO SLEEP SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 26 W DRY CREEK CIR SUITE 720
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City | LITTLETON
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State | CO
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Zip | 80120-8063
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Country | US
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Telephone | 303-794-2258
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Fax | 303-794-3599
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Provider Business Mailing Address
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Address Line | 26 W DRY CREEK CIR SUITE 720
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City | LITTLETON
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State | CO
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Zip | 80120-8063
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Country | US
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Telephone | 303-794-2258
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Fax | 303-794-3599
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. VICTOR BURDICK JR.
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Credential | D.D.S.
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Telephone | 303-794-2258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 6175
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License Number State | CO
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