Southern Minnesota Sleep Center, PLLC
Organization Active NPI General Practice Dentistry · Montgomery, MN
NPI 1750165171 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1750165171
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- SOUTHERN MINNESOTA SLEEP CENTER, PLLC
- Practice address
- 110 1St St N
Montgomery, MN 56069-1514 - Phone
- (920) 316-0002
- NPI assigned
- Aug 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Karisa Bollinger
- Title
- Marketing Manager
- Phone
- (507) 317-8039
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240426001557 | MN | DME Supplier - Oral Surgery - Dentist | 1456791250 | Practice locations: Montgomery, MN |
National Provider Directory
Locations
110 1st St N
Montgomery, MN 56069
Phone (507) 323-5959
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
110 1St St N
Montgomery, MN 56069-1514
Mailing address
110 1St St N
Montgomery, MN 56069-1514
Phone (920) 316-0002
Other names
- Southern Minnesota Sleep Center, PLLC
Other providers in Montgomery, MN
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- Recoveryde LLC
- Sapphire Counseling & Therapeutic
- Mary Lee Schrader
- Heidi Jolene Simon
- Spirits at Rest
- Kellee N. K. Stanton
- Alexandria Stepka
- Sunrise Farm, Inc.
- Hugh Thissen
All providers in Montgomery, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.