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Organization
SLEEP WELL IDAHO LLC
Active
Organization
SLEEP WELL IDAHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONTE CARLSON DDS (DENTIST)
(435) 881-7270
Entity
Organization
Contact information
Practice address
199 QUAIL HOLLOW RD, LOGAN, UT 84321-6750
(435) 881-7270
Mailing address
199 QUAIL HOLLOW RD, LOGAN, UT 84321-6750
(435) 881-7270
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H04018
N/A
UT
Enumeration date
05/29/2018
Last updated
05/29/2018
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