Provider Demographics
NPI:1144518804
Name:ACCESS SLEEP DENTAL ASSOCIATES LLC
Entity type:Organization
Organization Name:ACCESS SLEEP DENTAL ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GALLANOSA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-506-2997
Mailing Address - Street 1:3750 N MERIDIAN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4375
Mailing Address - Country:US
Mailing Address - Phone:317-283-2255
Mailing Address - Fax:317-283-2612
Practice Address - Street 1:3750 N MERIDIAN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4375
Practice Address - Country:US
Practice Address - Phone:317-283-2255
Practice Address - Fax:317-283-2612
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS DENTAL ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-15
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009962A332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment