Provider Demographics
NPI:1962680561
Name:OAKLEY FAMILY DENTISTRY
Entity Type:Organization
Organization Name:OAKLEY FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-531-1397
Mailing Address - Street 1:307 CASTLE SHANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234
Mailing Address - Country:US
Mailing Address - Phone:412-531-1397
Mailing Address - Fax:
Practice Address - Street 1:307 CASTLE SHANNON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234
Practice Address - Country:US
Practice Address - Phone:412-531-1397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS016239L122300000X
PADS028434L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty