Provider Demographics
NPI:1831239292
Name:HEADACHE TMJ AND NECK PAIN SOLUTIONS PLC
Entity type:Organization
Organization Name:HEADACHE TMJ AND NECK PAIN SOLUTIONS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-358-5500
Mailing Address - Street 1:PO BOX 2130
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-2130
Mailing Address - Country:US
Mailing Address - Phone:248-358-5500
Mailing Address - Fax:248-386-9816
Practice Address - Street 1:26400 W 12 MILE RD STE 115
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1771
Practice Address - Country:US
Practice Address - Phone:248-358-5500
Practice Address - Fax:248-386-9816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITV013887261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental