Provider Demographics
NPI:1669674263
Name:FOX & ELLIS ENDODONTICS PARTNERSHIP
Entity Type:Organization
Organization Name:FOX & ELLIS ENDODONTICS PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-756-1676
Mailing Address - Street 1:2040 N LOOP 336 W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3500
Mailing Address - Country:US
Mailing Address - Phone:936-756-1676
Mailing Address - Fax:936-756-1675
Practice Address - Street 1:2040 N LOOP 336 W
Practice Address - Street 2:SUITE 300
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3500
Practice Address - Country:US
Practice Address - Phone:936-756-1676
Practice Address - Fax:936-756-1675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty