Provider Demographics
NPI:1437665767
Name:MID- MICHIGAN DENTAL SLEEP CENTER
Entity Type:Organization
Organization Name:MID- MICHIGAN DENTAL SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYRAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-485-1900
Mailing Address - Street 1:601 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-2424
Mailing Address - Country:US
Mailing Address - Phone:517-485-1900
Mailing Address - Fax:
Practice Address - Street 1:601 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-2424
Practice Address - Country:US
Practice Address - Phone:517-485-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment