Provider Demographics
NPI:1548948649
Name:SAFFORD, SOPHIA (DMD)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:SAFFORD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6649 RIDGE AVENUE
Mailing Address - Street 2:BLDG. A, APARTMENT A415
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128
Mailing Address - Country:US
Mailing Address - Phone:717-304-1096
Mailing Address - Fax:
Practice Address - Street 1:1189 E PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6307
Practice Address - Country:US
Practice Address - Phone:443-406-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18131122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty