Provider Demographics
NPI:1013051374
Name:THE FACIAL SURGERY CENTER
Entity Type:Organization
Organization Name:THE FACIAL SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALUSIC
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-547-0999
Mailing Address - Street 1:220 BESSEMER RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-9122
Mailing Address - Country:US
Mailing Address - Phone:724-547-0999
Mailing Address - Fax:724-547-5345
Practice Address - Street 1:220 BESSEMER RD
Practice Address - Street 2:SUITE 302
Practice Address - City:MOUNT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-9122
Practice Address - Country:US
Practice Address - Phone:724-547-0999
Practice Address - Fax:724-547-5345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021856L .DS027205L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1659484665OtherDR BENDER'S NPI
PA1659484665OtherDR BENDER'S NPI
PAHA109016Medicare UPIN
PABE1617298Medicare UPIN