# KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427457191
- **Authorized official:** MR. ANTHONY E KASPER DDS (OWNER)
- **Authorized official phone:** (586) 914-0093

## Contact information

- **Practice address:** 36975 UTICA RD, SUITE 106, CLINTON TOWNSHIP, MI 48036-1685
- **Practice address phone:** (586) 226-2801
- **Practice address fax:** (586) 226-1519
- **Mailing address:** 36975 UTICA RD, SUITE 106, CLINTON TOWNSHIP, MI 48036-1685
- **Mailing address phone:** (586) 226-2801
- **Mailing address fax:** (586) 226-1519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2901017390 | MI | Yes |

## Other

- **Enumeration date:** 08/19/2014
- **Last updated:** 10/27/2014