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Organization
INSTITUTE FOR THE TREATMENT OF CRANIOFACIAL PAIN, PA
Active
Organization
INSTITUTE FOR THE TREATMENT OF CRANIOFACIAL PAIN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN D. FUSELIER DDS (OWNER)
(407) 963-0553
Entity
Organization
Contact information
Practice address
2122 E ROBINSON ST, ORLANDO, FL 32803-6047
(407) 963-0553
(407) 637-5183
Mailing address
1203 PRESERVE POINT DR, WINTER PARK, FL 32789-5939
(407) 963-0553
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/07/2019
Last updated
07/16/2019
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