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General NPI Number Information
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NPI Number | 1407419799
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Entity Type | Organization
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Legal Business Name | SLEEP BETTER DENTAL MEDICINE OF THE MAIN LINE
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 919 CONESTOGA RD
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City | BRYN MAWR
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State | PA
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Zip | 19010-1352
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Country | US
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Telephone | 610-234-3881
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Fax |
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Provider Business Mailing Address
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Address Line | 919 CONESTOGA RD BUILDING ONE SUITE 100
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City | BRYN MAWR
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State | PA
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Zip | 19010
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Country | US
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Telephone | 610-234-3881
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Fax | 610-525-3628
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Authorized Official
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Title or Position | OWNER
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Name | AMY SHOUMER
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Credential | DMD
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Telephone | 610-234-3881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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