Organization
SWALLOWTAIL SLEEP CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MOSHER (OWNER)
(330) 904-7753
Entity
Organization
Contact information
Practice address
2400 WALES AVE NW STE J, MASSILLON, OH 44646-2367
(330) 904-7753
Mailing address
2400 WALES AVE NW STE J, MASSILLON, OH 44646-2367
(330) 832-4533
(330) 832-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/31/2019
Last updated
09/17/2020
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