Provider Demographics
NPI:1790749554
Name:FOX, MATTHEW ZANE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ZANE
Last Name:FOX
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19475 N GRAYHAWK DR UNIT 1115
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7421
Mailing Address - Country:US
Mailing Address - Phone:248-755-3520
Mailing Address - Fax:
Practice Address - Street 1:7342 E THOMAS RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7243
Practice Address - Country:US
Practice Address - Phone:480-935-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010187081223G0001X
AZD0084961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice