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General NPI Number Information
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NPI Number | 1164921292
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Entity Type | Organization
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Legal Business Name | ADVANCED SLEEP TREATMENT CO
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Dates
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Enumeration Date | 02/05/2018
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 10230 NEW HAMPSHIRE AVE STE 330
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City | SILVER SPRING
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State | MD
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Zip | 20903
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Country | US
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Telephone | 301-439-8333
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Fax | 301-439-4622
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Provider Business Mailing Address
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Address Line | 10230 NEW HAMPSHIRE AVE STE 330
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City | SILVER SPRING
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State | MD
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Zip | 20903-1418
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Country | US
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Telephone | 301-439-8333
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Fax | 301-439-4622
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Authorized Official
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Title or Position | OWNER
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Name | EKATERINA TOMENKO
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Credential |
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Telephone | 301-439-8333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14794
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 14794
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License Number State | MD
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