Provider Demographics
NPI:1144546441
Name:SNORING AND SLEEP APNEA CENTER PA
Entity type:Organization
Organization Name:SNORING AND SLEEP APNEA CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-262-7645
Mailing Address - Street 1:13734 1ST ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-9337
Mailing Address - Country:US
Mailing Address - Phone:763-262-7645
Mailing Address - Fax:763-262-2345
Practice Address - Street 1:13734 1ST ST
Practice Address - Street 2:SUITE B
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308-9337
Practice Address - Country:US
Practice Address - Phone:763-262-7645
Practice Address - Fax:763-262-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6394460001Medicare NSC