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General NPI Number Information
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NPI Number | 1861966921
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Entity Type | Organization
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Legal Business Name | MIDWEST SLEEP AND SNORE TREATMENT LLC
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Dates
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Enumeration Date | 01/11/2019
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 2758 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-1402
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Country | US
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Telephone | 314-606-8383
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Fax |
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Provider Business Mailing Address
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Address Line | 2758 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-1402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRY DYER
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Credential | DMD
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Telephone | 314-606-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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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