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General NPI Number Information
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NPI Number | 1225536469
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Entity Type | Organization
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Legal Business Name | FUNKTIONAL SLEEP PLLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 1200 S LIVERNOIS RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2978
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Country | US
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Telephone | 248-924-9244
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 S LIVERNOIS RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2978
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | DR. ERIC JASON KOSNIC
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Credential | DDS
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Telephone | 248-709-0979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901012911
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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