| Institute For The Treatment Of Craniofacial Pain, Pa | |
|
2122 E Robinson St Orlando FL 32803-6047 | |
| (407) 963-0553 | |
| (407) 637-5183 |
| Full Name | Institute For The Treatment Of Craniofacial Pain, Pa |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2122 E Robinson St, Orlando, Florida |
| Authorized Official Name and Position | Brian D. Fuselier (OWNER) |
| Authorized Official Contact | 4079630553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Institute For The Treatment Of Craniofacial Pain, Pa 1203 Preserve Point Dr Winter Park FL 32789-5939 Ph: (407) 963-0553 | Institute For The Treatment Of Craniofacial Pain, Pa 2122 E Robinson St Orlando FL 32803-6047 Ph: (407) 963-0553 |
| NPI Number | 1952866600 |
|---|---|
| Provider Enumeration Date | 02/07/2019 |
| Last Update Date | 07/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952866600 | NPI | - | NPPES |
| 1700859063 | Other | FL | OMS |
| 1265405518 | Other | FL | OMS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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