Provider Demographics
NPI:1477951150
Name:SYLVAN STERN DENTAL SLEEP MEDICINE PLC
Entity Type:Organization
Organization Name:SYLVAN STERN DENTAL SLEEP MEDICINE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLVAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-559-0995
Mailing Address - Street 1:17040 W 12 MILE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2131
Mailing Address - Country:US
Mailing Address - Phone:248-559-0995
Mailing Address - Fax:248-559-6724
Practice Address - Street 1:17040 W 12 MILE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2131
Practice Address - Country:US
Practice Address - Phone:248-559-0995
Practice Address - Fax:248-559-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12882122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty