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General NPI Number Information
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NPI Number | 1316348261
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Entity Type | Organization
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Legal Business Name | SLEEP DIAGNOSTICS INC
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 448 36TH AVE NW STE 102
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City | NORMAN
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State | OK
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Zip | 73072-4743
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Country | US
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Telephone | 405-321-0111
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Fax | 405-321-2108
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Provider Business Mailing Address
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Address Line | 448 36TH AVE NW STE 102
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City | NORMAN
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State | OK
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Zip | 73072-4743
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Country | US
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Telephone | 405-321-0111
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Fax | 405-321-2108
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA JOHNSON TALLEY
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Credential |
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Telephone | 405-321-0111
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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 | 03515
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License Number State | OK
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