# MICHIGAN DENTAL SLEEP CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376908392
- **Authorized official:** DR. CHAD M WITKOW DDS (PRESIDENT)
- **Authorized official phone:** (810) 659-1721

## Contact information

- **Practice address:** 4279 W VIENNA RD, CLIO, MI 48420-9440
- **Practice address phone:** (810) 659-1721
- **Practice address fax:** (810) 659-0897
- **Mailing address:** 4279 W VIENNA RD, CLIO, MI 48420-9440
- **Mailing address phone:** (810) 659-1721
- **Mailing address fax:** (810) 659-0897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | — | — |

## Other

- **Enumeration date:** 12/17/2015
- **Last updated:** 04/25/2022