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General NPI Number Information
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NPI Number | 1801291315
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE SLEEP, PLC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 24 FRANK LLOYD WRIGHT DRIVE LOBBY A
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City | ANN ARBOR
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State | MI
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Zip | 48106-0326
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Country | US
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Telephone | 734-930-4022
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Fax | 734-930-4029
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DRIVE LOBBY A
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City | ANN ARBOR
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State | MI
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Zip | 48106-0326
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Country | US
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Telephone | 734-930-4022
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Fax | 734-930-4029
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Authorized Official
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Title or Position | MEMBER
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Name | MERIDITH L HALL
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Credential | DDS
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Telephone | 734-930-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301096549
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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 | 2901017411
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License Number State | MI
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