Healthcare Provider Details

I. General information

NPI: 1538425954
Provider Name (Legal Business Name): SLEEP DISORDERS-ORAL SOLUTIONS FOR TOTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3684 W MAPLE RD
BLOOMFIELD HILLS MI
48301-3375
US

IV. Provider business mailing address

3684 W MAPLE RD
BLOOMFIELD HILLS MI
48301-3375
US

V. Phone/Fax

Practice location:
  • Phone: 248-642-1000
  • Fax: 248-642-1004
Mailing address:
  • Phone: 248-642-1000
  • Fax: 248-642-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number16969
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS G THOMPSON
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 248-642-1000