Provider Demographics
NPI:1750844080
Name:C.M.F.-CRANIO-MAXILLOFACIAL SURGERY ASSOCIATES
Entity type:Organization
Organization Name:C.M.F.-CRANIO-MAXILLOFACIAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:MARX
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:617-628-8000
Mailing Address - Street 1:366 BROADWAY STE 100
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-2812
Mailing Address - Country:US
Mailing Address - Phone:617-628-8000
Mailing Address - Fax:617-628-2370
Practice Address - Street 1:287 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5056
Practice Address - Country:US
Practice Address - Phone:617-286-5780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory SurgicalGroup - Single Specialty