Provider Demographics
NPI:1205847019
Name:FOX, DAVID GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GEORGE
Last Name:FOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 ANN ST.
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-2015
Mailing Address - Country:US
Mailing Address - Phone:570-421-2320
Mailing Address - Fax:570-421-2320
Practice Address - Street 1:606 ANN ST.
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2015
Practice Address - Country:US
Practice Address - Phone:570-421-2320
Practice Address - Fax:570-421-2320
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD5019031L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist