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General NPI Number Information
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NPI Number | 1942945225
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Entity Type | Organization
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Legal Business Name | MIDWEST SLEEP CENTER, PC
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 201 N CONSTITUTION DR STE 108
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City | AURORA
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State | IL
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Zip | 60506-3200
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Country | US
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Telephone | 630-730-0235
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N CONSTITUTION DR
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City | AURORA
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State | IL
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Zip | 60506-3214
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Country | US
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Telephone | 630-730-0235
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN GOETZ
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Credential | D.D.S.
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Telephone | 847-254-3819
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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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