Provider Demographics
NPI:1942850573
Name:ROXBURY FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:ROXBURY FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-584-1066
Mailing Address - Street 1:168 ROUTE 10 W
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1434
Mailing Address - Country:US
Mailing Address - Phone:973-584-1066
Mailing Address - Fax:973-584-6790
Practice Address - Street 1:168 ROUTE 10 W
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1434
Practice Address - Country:US
Practice Address - Phone:973-584-1066
Practice Address - Fax:973-584-6790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty