=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730658618
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUND SLEEP PITTSBURGH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2018
-----------------------------------------------------
Last Update Date | 09/03/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 PENN CENTER BLVD STE 210
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15235-5502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-825-0200
-----------------------------------------------------
Fax | 412-825-4627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 PENN CENTER BLVD STE 210
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15235-5502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-825-0200
-----------------------------------------------------
Fax | 412-825-4627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST/OWNER
-----------------------------------------------------
Name | DR. DAVID PAUL DZUBAN
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 412-825-0200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------