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General NPI Number Information
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NPI Number | 1396075024
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Entity Type | Organization
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Legal Business Name | GEORGE S. YATROS DENTAL SLEEP, LLC
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 402 43RD ST W STE A
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City | BRADENTON
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State | FL
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Zip | 34209-2953
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Country | US
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Telephone | 941-757-4642
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Fax | 844-868-4098
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Provider Business Mailing Address
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Address Line | 402 43RD ST W STE A
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City | BRADENTON
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State | FL
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Zip | 34209-2953
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Country | US
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Telephone | 941-757-4642
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Fax | 844-868-4098
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE S YATROS
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Credential | D.M.D.
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Telephone | 941-757-4642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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