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General NPI Number Information
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NPI Number | 1649742099
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Entity Type | Organization
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Legal Business Name | SLEEP THERAPY LLC
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 20405 EXCHANGE ST STE 201
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City | ASHBURN
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State | VA
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Zip | 20147-5934
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Country | US
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Telephone | 703-297-4407
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Fax | 703-297-4421
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Provider Business Mailing Address
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Address Line | 20405 EXCHANGE ST STE 201
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City | ASHBURN
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State | VA
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Zip | 20147-5934
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Country | US
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Telephone | 703-297-4407
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Fax | 703-297-4421
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Authorized Official
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Title or Position | OWNER
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Name | MAYA BACHOUR
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Credential | DDS
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Telephone | 703-297-4407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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