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General NPI Number Information
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NPI Number | 1215124672
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Entity Type | Organization
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Legal Business Name | FACIAL PAIN AND SLEEP CENTER PLC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 3144 JOHN R RD SUITE 100
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City | TROY
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State | MI
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Zip | 48083
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Country | US
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Telephone | 248-519-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 3144 JOHN R RD SUITE 100
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City | TROY
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State | MI
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Zip | 48083
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Country | US
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Telephone | 248-519-1100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GHABI A. KASPO
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Credential | DDS
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Telephone | 248-519-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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