Provider Demographics
NPI:1124212485
Name:JOHN P. FOX DDS, PC
Entity Type:Organization
Organization Name:JOHN P. FOX DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:706-265-1700
Mailing Address - Street 1:671 LUMPKIN CAMPGROUND RD S
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0922
Mailing Address - Country:US
Mailing Address - Phone:706-265-1700
Mailing Address - Fax:706-265-1702
Practice Address - Street 1:671 LUMPKIN CAMPGROUND RD S
Practice Address - Street 2:SUITE 110
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-0922
Practice Address - Country:US
Practice Address - Phone:706-265-1700
Practice Address - Fax:706-265-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0124741223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA19NCCCHMedicare PIN
GAU32329Medicare UPIN