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General NPI Number Information
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NPI Number | 1134683147
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Entity Type | Organization
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Legal Business Name | SLEEP WELL DICKSON
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Dates
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Enumeration Date | 01/23/2019
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 320 E COLLEGE ST STE A
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City | DICKSON
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State | TN
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Zip | 37055-1893
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Country | US
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Telephone | 615-740-7645
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Fax |
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Provider Business Mailing Address
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Address Line | 320 E COLLEGE ST STE A
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City | DICKSON
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State | TN
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Zip | 37055-1893
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Country | US
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Telephone | 615-740-7645
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MELISSA GARLENE JORDAN
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Credential |
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Telephone | 615-740-7645
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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 |
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License Number State |
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