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General NPI Number Information
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NPI Number | 1881196293
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Entity Type | Organization
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Legal Business Name | EASTON SNORING AND SLEEP APNEA CENTER LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 213 PARKS RD
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City | CHESTER
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State | MD
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Zip | 21619-2224
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Country | US
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Telephone | 410-739-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 1253 SCALP AVE STE 105
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City | JOHNSTOWN
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State | PA
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Zip | 15904-3137
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Country | US
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Telephone | 814-266-1070
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Fax | 814-266-5881
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMUAL C POLLINA
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Credential | DMD
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Telephone | 410-739-4465
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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 | 15932
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License Number State | MD
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