# MAXILLOFACIAL SURGICAL ASSOCIATES, P.C.

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

## Provider details

- **NPI number:** 1942573902
- **Authorized official:** DR. ALLAN S. SHAW D.D.S. (PRESIDENT)
- **Authorized official phone:** (215) 640-0811

## Contact information

- **Practice address:** 1601 WALNUT ST, SUITE 1116, PHILADELPHIA, PA 19102-2944
- **Practice address phone:** (215) 640-0811
- **Practice address fax:** (215) 640-0912
- **Mailing address:** 1601 WALNUT ST, SUITE 1116, PHILADELPHIA, PA 19102-2944
- **Mailing address phone:** (215) 640-0811
- **Mailing address fax:** (215) 640-0912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2012
- **Last updated:** 02/21/2012