Provider Demographics
NPI:1548337199
Name:HEADACHE, NECK & FACIAL PAIN CLINIC PC
Entity type:Organization
Organization Name:HEADACHE, NECK & FACIAL PAIN CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEMT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWARB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-358-5500
Mailing Address - Street 1:29355 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1053
Mailing Address - Country:US
Mailing Address - Phone:248-358-5500
Mailing Address - Fax:248-386-9816
Practice Address - Street 1:29355 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1053
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:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDS011932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU30007Medicare UPIN
MI0N8320001Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION