Healthcare Provider Details

I. General information

NPI: 1972555787
Provider Name (Legal Business Name): METROPOLITAN SLEEP DISORDERS CENTER, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 SMITH AVE N SUITE 203
SAINT PAUL MN
55102-2572
US

IV. Provider business mailing address

255 SMITH AVE N SUITE 203
SAINT PAUL MN
55102-2572
US

V. Phone/Fax

Practice location:
  • Phone: 651-298-0350
  • Fax: 651-298-0301
Mailing address:
  • Phone: 651-298-0350
  • Fax: 651-298-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS G. LORENTZEN
Title or Position: CEO
Credential:
Phone: 651-224-5895