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General NPI Number Information
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NPI Number | 1306332283
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Entity Type | Organization
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Legal Business Name | GREAT NIGHT SLEEP COMPANY LLC
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 1309 AVON TER
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City | SOUTHLAKE
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State | TX
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Zip | 76092-9509
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Country | US
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Telephone | 214-924-1114
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Fax | 214-924-1114
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Provider Business Mailing Address
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Address Line | 1309 AVON TER
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City | SOUTHLAKE
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State | TX
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Zip | 76092-9509
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Country | US
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Telephone | 214-924-1114
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Fax | 214-924-1114
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Authorized Official
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Title or Position | OWNER
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Name | DR. HUGH WILKINSON OSER
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Credential | DDS
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Telephone | 214-924-1114
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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 | 11701
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License Number State | TX
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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 | 11701
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License Number State | TX
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