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General NPI Number Information
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NPI Number | 1609632678
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Entity Type | Organization
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Legal Business Name | HEAD PAIN INSTITUTE LLC
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 9481 E IRONWOOD SQUARE DR STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4568
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Country | US
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Telephone | 480-945-3629
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Fax | 480-664-8972
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Provider Business Mailing Address
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Address Line | 9481 E IRONWOOD SQUARE DR STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4568
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Country | US
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Telephone | 480-945-3629
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Fax | 480-664-8972
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Authorized Official
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Title or Position | OWNER
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Name | ANTONIA MARIA TERUEL CASTELLON
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Credential | DMD
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Telephone | 480-945-3629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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