Provider Demographics
NPI:1689783862
Name:FOX, DARRELL FRANCIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:FRANCIS
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 1:1709 MCNAUGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-2835
Mailing Address - Country:US
Mailing Address - Phone:712-262-4382
Mailing Address - Fax:712-262-9650
Practice Address - Street 1:1709 MCNAUGHTON WAY
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-2835
Practice Address - Country:US
Practice Address - Phone:712-262-4382
Practice Address - Fax:712-262-9650
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA67791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0194647Medicaid