# EP DENTAL SLEEP MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Koala Center for Sleep Disorders
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114407970
- **Authorized official:** BRYAN KALISH DDS (OWNER)
- **Authorized official phone:** (915) 881-9898

## Contact information

- **Practice address:** 6901 HELEN OF TROY STE D2, EL PASO, TX 79911-3130
- **Practice address phone:** (815) 881-9898
- **Mailing address:** 11825 STATE ROUTE 40 STE 100, DUNLAP, IL 61525-8842
- **Mailing address phone:** (309) 839-9971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 23551 | TX | Yes |

## Other

- **Enumeration date:** 08/20/2018
- **Last updated:** 06/12/2019