# SOUTHERN NEW JERSEY ORAL SURGERY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538573720
- **Authorized official:** SHARIQ AZIZ VAZIR DDS (PRESIDENT)
- **Authorized official phone:** (856) 428-4445

## Contact information

- **Practice address:** 17 W ORMOND AVE, CHERRY HILL, NJ 08002-3041
- **Practice address phone:** (856) 428-4445
- **Practice address fax:** (856) 428-4497
- **Mailing address:** 17 W ORMOND AVE, CHERRY HILL, NJ 08002-3041
- **Mailing address phone:** (856) 428-4445
- **Mailing address fax:** (856) 428-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22DI02490200 | NJ | Yes |

## Other

- **Enumeration date:** 06/16/2014
- **Last updated:** 06/16/2014