Provider Demographics
NPI:1609632678
Name:HEAD PAIN INSTITUTE LLC
Entity Type:Organization
Organization Name:HEAD PAIN INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:TERUEL CASTELLON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-945-3629
Mailing Address - Street 1:9481 E IRONWOOD SQUARE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4568
Mailing Address - Country:US
Mailing Address - Phone:480-945-3629
Mailing Address - Fax:480-664-8972
Practice Address - Street 1:9481 E IRONWOOD SQUARE DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4568
Practice Address - Country:US
Practice Address - Phone:480-945-3629
Practice Address - Fax:480-664-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty