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KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC NPI 1427457191


NPI Information

NPI: 1427457191
Provider Name: KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
36975 UTICA RD
SUITE 106
CLINTON TOWNSHIP, MI
ZIP 48036
Phone: (586) 226-2801
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KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC is an oral and maxillofacial surgery dentist in Clinton Township, MI. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC NPI is 1427457191. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

36975 UTICA RD
SUITE 106
CLINTON TOWNSHIP, MI
ZIP 48036-685
Phone: (586) 226-2801
Fax: (586) 226-1519

The provider's authorized official is Anthony E Kasper .
The authorized official title is Owner and has the following contact phone number (586) 914-0093.

The enumeration date for this NPI number is 8/19/2014 and was last updated on 10/27/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery2901017390MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10E04308OTHERMICHIGANBLUE CROSS BLUE SHIELD
2MI7945MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.