Provider Demographics
NPI:1871205609
Name:DENTAL SLEEP SOLUTIONS OF WNY
Entity type:Organization
Organization Name:DENTAL SLEEP SOLUTIONS OF WNY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIBICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-634-1234
Mailing Address - Street 1:34 WIK ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5340
Mailing Address - Country:US
Mailing Address - Phone:716-472-4246
Mailing Address - Fax:
Practice Address - Street 1:6600 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5933
Practice Address - Country:US
Practice Address - Phone:716-634-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental