Provider Demographics
NPI:1669834248
Name:DR ROXAS PC
Entity Type:Organization
Organization Name:DR ROXAS PC
Other - Org Name:BLANC DENTAL STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROXAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:267-379-7570
Mailing Address - Street 1:716 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3201
Mailing Address - Country:US
Mailing Address - Phone:267-379-7570
Mailing Address - Fax:267-379-7501
Practice Address - Street 1:716 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3201
Practice Address - Country:US
Practice Address - Phone:267-379-7570
Practice Address - Fax:267-379-7501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037863122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty