Provider Demographics
NPI:1609917517
Name:FOX, BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3155 STATE ROUTE 10
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-3492
Mailing Address - Country:US
Mailing Address - Phone:973-328-4434
Mailing Address - Fax:973-328-8898
Practice Address - Street 1:3155 STATE ROUTE 10
Practice Address - Street 2:SUITE 111
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3492
Practice Address - Country:US
Practice Address - Phone:973-328-4434
Practice Address - Fax:973-328-8898
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI-141061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics