Provider Demographics
NPI:1376375204
Name:SLEEP TIGHT IDAHO
Entity type:Organization
Organization Name:SLEEP TIGHT IDAHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAWS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:208-922-4149
Mailing Address - Street 1:935 N LINDER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-1204
Mailing Address - Country:US
Mailing Address - Phone:208-922-4149
Mailing Address - Fax:
Practice Address - Street 1:935 N LINDER RD STE 101
Practice Address - Street 2:
Practice Address - City:KUNA
Practice Address - State:ID
Practice Address - Zip Code:83634-1204
Practice Address - Country:US
Practice Address - Phone:208-922-4149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUNA DENTAL FAMILY COSMETIC & CHILDREN'S DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty