Healthcare Provider Details

I. General information

NPI: 1962960096
Provider Name (Legal Business Name): METRO DETROIT SLEEP SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42490 GARFIELD RD STE 201
CLINTON TOWNSHIP MI
48038-4200
US

IV. Provider business mailing address

42490 GARFIELD RD STE 201
CLINTON TOWNSHIP MI
48038-4200
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-1241
  • Fax: 586-263-9588
Mailing address:
  • Phone: 586-263-1241
  • Fax: 586-263-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THOMAS MICHAEL KACHOREK
Title or Position: OWNER
Credential: DDS
Phone: 586-263-1241