Provider Demographics
NPI:1427363589
Name:OX ORTHODONTIX, LLC
Entity Type:Organization
Organization Name:OX ORTHODONTIX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-740-0002
Mailing Address - Street 1:5082 DORSEY HALL DR
Mailing Address - Street 2:STE. 202
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7847
Mailing Address - Country:US
Mailing Address - Phone:410-740-0002
Mailing Address - Fax:410-740-0930
Practice Address - Street 1:5082 DORSEY HALL DR
Practice Address - Street 2:STE. 202
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7847
Practice Address - Country:US
Practice Address - Phone:410-740-0002
Practice Address - Fax:410-740-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD87601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty