Organization
AMERICAN SLEEP DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE JASPER GRAVES DDS (MANAGING PARTNER)
(228) 897-1636
Entity
Organization
Contact information
Practice address
106 WILLOW CREEK DR, LONG BEACH, MS 39560-3311
(228) 865-3998
(228) 865-1665
Mailing address
PO BOX 660, LONG BEACH, MS 39560-0660
(228) 865-3998
(228) 865-1665
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125706
—
MS
Enumeration date
07/11/2006
Last updated
08/22/2020
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