Provider Demographics
NPI:1770357485
Name:THE SLEEP CENTER LLC
Entity type:Organization
Organization Name:THE SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-818-0942
Mailing Address - Street 1:1145 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:WEISER
Mailing Address - State:ID
Mailing Address - Zip Code:83672-1163
Mailing Address - Country:US
Mailing Address - Phone:206-818-0942
Mailing Address - Fax:
Practice Address - Street 1:513 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEISER
Practice Address - State:ID
Practice Address - Zip Code:83672-2225
Practice Address - Country:US
Practice Address - Phone:986-942-9105
Practice Address - Fax:855-811-3293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty