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General NPI Number Information
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NPI Number | 1902621022
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Entity Type | Organization
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Legal Business Name | COMPLETE SLEEP DENTISTRY OF VIRGINIA, P.C.
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 780 LYNNHAVEN PKWY STE 400
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7332
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Country | US
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Telephone | 888-835-0988
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 6TH AVE RM 701
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City | NEW YORK
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State | NY
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Zip | 10018-5487
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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 | MANAGER
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Name | ANDRES MORAN
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Credential |
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Telephone | 305-799-6184
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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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