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General NPI Number Information
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NPI Number | 1912498148
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Entity Type | Organization
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Legal Business Name | WOODBURY SLEEP SOLUTIONS PA
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Dates
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Enumeration Date | 05/23/2018
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Last Update Date | 05/23/2018
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Provider Practice Location Address
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Address Line | 2070 EAGLE CREEK LN STE 300
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City | WOODBURY
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State | MN
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Zip | 55129-3218
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Country | US
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Telephone | 651-439-7559
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Fax | 651-436-7553
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Provider Business Mailing Address
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Address Line | 2070 EAGLE CREEK LN STE 300
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City | WOODBURY
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State | MN
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Zip | 55129-3218
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Country | US
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Telephone | 651-439-7559
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Fax | 651-436-7553
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Authorized Official
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Title or Position | OWNER
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Name | MARKO KAMEL
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Credential |
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Telephone | 651-436-7559
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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 | D12206
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License Number State | MN
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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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