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General NPI Number Information
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NPI Number | 1477951150
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Entity Type | Organization
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Legal Business Name | SYLVAN STERN DENTAL SLEEP MEDICINE PLC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 17040 W 12 MILE RD SUITE 150
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2131
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Country | US
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Telephone | 248-559-0995
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Fax | 248-559-6724
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Provider Business Mailing Address
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Address Line | 17040 W 12 MILE RD SUITE 150
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2131
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Country | US
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Telephone | 248-559-0995
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Fax | 248-559-6724
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. SYLVAN S STERN
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Credential | DDS
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Telephone | 248-559-0995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 12882
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12882
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License Number State | MI
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