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Organization

PRAIRIE SLEEP CENTER LLC

Active
Parent organization
TANYA L DESANTO DDS
Organization subpart
Yes

Provider details

NPI number
Legal business name
TANYA L DESANTO DDS
Authorized official
DR. TANYA L DESANTO (DENTIST/OWNER)
(217) 546-0412
Entity
Organization

Contact information

Practice address
2900 GREENBRIAR DR, SPRINGFIELD, IL 62704-6418
(217) 546-0412
(217) 546-0919
Mailing address
2900 GREENBRIAR DR, SPRINGFIELD, IL 62704-6418
(217) 546-0412
(217) 546-0919

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1285778522
DENTIST
IL
Enumeration date
09/19/2019
Last updated
09/02/2025
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