Organization
ALLIANCE ORTHO SLEEP P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN EATMON DDS (MEDICAL DIRECTOR)
(631) 374-3410
Entity
Organization
Contact information
Practice address
2931 GREY MOSS PASS, DULUTH, GA 30097-6274
(631) 374-3410
Mailing address
2437 ROCKVILLE CENTRE PKWY, OCEANSIDE, NY 11572-1622
(516) 640-7401
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
—
—
261QD0000X
Dental Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/17/2024
Last updated
05/17/2024
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