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General NPI Number Information
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NPI Number | 1992631121
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Entity Type | Organization
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Legal Business Name | GREAT LAKES AIRWAY AND SLEEP PLLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 5730 N LILLEY RD STE D
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City | CANTON
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State | MI
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Zip | 48187-3685
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Country | US
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Telephone | 734-335-0820
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Fax |
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Provider Business Mailing Address
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Address Line | 9254 MARLOWE AVE
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City | PLYMOUTH
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State | MI
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Zip | 48170-4038
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Country | US
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Telephone | 734-679-8898
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | HALEY LAWRENCE-PUMMILL
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Credential | DDS
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Telephone | 734-679-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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