Provider Demographics
NPI:1679189104
Name:MICHIGAN CENTER FOR TMJ AND SLEEP WELLNESS
Entity Type:Organization
Organization Name:MICHIGAN CENTER FOR TMJ AND SLEEP WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SAHED
Authorized Official - Last Name:HADDAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-480-0085
Mailing Address - Street 1:4550 INVESTMENT DR STE 290
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6362
Mailing Address - Country:US
Mailing Address - Phone:248-480-0085
Mailing Address - Fax:
Practice Address - Street 1:4550 INVESTMENT DR STE 290
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6362
Practice Address - Country:US
Practice Address - Phone:248-480-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty