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General NPI Number Information
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NPI Number | 1427491471
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Entity Type | Organization
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Legal Business Name | FIELD DENTAL SLEEP THERAPY, LLC
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 3020 N MILITARY TRL SUITE 250
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City | BOCA RATON
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State | FL
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Zip | 33431-1814
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Country | US
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Telephone | 561-443-4133
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Fax | 561-443-3670
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Provider Business Mailing Address
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Address Line | 3020 N MILITARY TRL SUITE 250
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City | BOCA RATON
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State | FL
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Zip | 33431-1814
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Country | US
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Telephone | 561-443-4133
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Fax | 561-443-3670
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Authorized Official
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Title or Position | OWNER
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Name | DR. THEODORE FIELD
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Credential | DDS
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Telephone | 561-443-4133
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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 | DN16163
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License Number State | FL
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