Provider Demographics
NPI:1619206612
Name:FOX, MARIA E (DMD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
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 1:510 N. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114
Mailing Address - Country:US
Mailing Address - Phone:509-684-5800
Mailing Address - Fax:509-684-5900
Practice Address - Street 1:510 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114
Practice Address - Country:US
Practice Address - Phone:509-684-5800
Practice Address - Fax:509-684-5900
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00080181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice