Provider Demographics
NPI:1407876030
Name:FOX, BECKY (DMD)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 JONESTOWN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-1700
Mailing Address - Country:US
Mailing Address - Phone:717-995-3590
Mailing Address - Fax:717-995-3591
Practice Address - Street 1:4813 JONESTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1700
Practice Address - Country:US
Practice Address - Phone:717-995-3590
Practice Address - Fax:717-995-3591
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030186L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice