Healthcare Provider Details

I. General information

NPI: 1942834502
Provider Name (Legal Business Name): AMP SLEEP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2020
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44004 WOODWARD AVE STE 200
BLOOMFIELD HILLS MI
48302-5032
US

IV. Provider business mailing address

44004 WOODWARD AVE STE 200
BLOOMFIELD HILLS MI
48302-5032
US

V. Phone/Fax

Practice location:
  • Phone: 248-334-3888
  • Fax: 248-334-5053
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA MICHELLE PERI
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 248-334-3888