| Dental Sleep Doc | |
|
3020 Sunset Blvd Ste 106 West Columbia SC 29169-3494 | |
| (803) 233-1980 | |
| (803) 602-6397 |
| Full Name | Dental Sleep Doc |
|---|---|
| Speciality | Dentist |
| Location | 3020 Sunset Blvd Ste 106, West Columbia, South Carolina |
| Authorized Official Name and Position | Erica Marguerite Johannes (PRESIDENT) |
| Authorized Official Contact | 9202549865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Sleep Doc 112 Mallard Lakes Ct Lexington SC 29072-9300 Ph: (920) 254-9865 | Dental Sleep Doc 3020 Sunset Blvd Ste 106 West Columbia SC 29169-3494 Ph: (803) 233-1980 |
| NPI Number | 1982105904 |
|---|---|
| Provider Enumeration Date | 02/25/2018 |
| Last Update Date | 07/22/2021 |
| Medicare PECOS PAC ID | 1850641952 |
|---|---|
| Medicare Enrollment ID | O20180911003423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982105904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4571 (South Carolina) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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