Provider Demographics
NPI:1831423425
Name:OXFORD CROSSING FAMILY AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:OXFORD CROSSING FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL HYGIENIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFIEYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:215-499-3537
Mailing Address - Street 1:333 S. OXFORD VALLEY ROAD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030
Mailing Address - Country:US
Mailing Address - Phone:215-269-1430
Mailing Address - Fax:216-269-4622
Practice Address - Street 1:333 N. OXFORD VALLEY ROAD
Practice Address - Street 2:SUITE 505
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030
Practice Address - Country:US
Practice Address - Phone:215-269-1430
Practice Address - Fax:216-269-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029267L1223G0001X
PADS029768L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty