# SAN DIEGO DENTAL SLEEP THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RICHARD B. EVANS, D.D.S., INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811259856
- **Legal business name:** RICHARD B. EVANS, D.D.S., INC.
- **Authorized official:** DR. RICHARD B EVANS D.D.S. (PRESIDENT)
- **Authorized official phone:** (619) 460-0714

## Contact information

- **Practice address:** 8530 LA MESA BLVD, SUITE 204, LA MESA, CA 91942-0966
- **Practice address phone:** (619) 460-0714
- **Practice address fax:** (619) 460-0707
- **Mailing address:** 8530 LA MESA BLVD, SUITE 204, LA MESA, CA 91942-0966
- **Mailing address phone:** (619) 460-0714
- **Mailing address fax:** (619) 460-0707

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 31914 | CA | Yes |
| 332BC3200X | Customized Equipment (DME) | 31914 | CA | — |
| 335E00000X | Prosthetic/Orthotic Supplier | 31914 | CA | — |

## Other

- **Enumeration date:** 06/14/2012
- **Last updated:** 06/14/2012