Provider Demographics
NPI:1942426358
Name:FOX, JOHN NELSON (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NELSON
Last Name:FOX
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Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:1300 N WESTWOOD BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901
Mailing Address - Country:US
Mailing Address - Phone:573-785-1466
Mailing Address - Fax:573-785-8566
Practice Address - Street 1:1300 N WESTWOOD BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901
Practice Address - Country:US
Practice Address - Phone:573-785-1466
Practice Address - Fax:573-785-8566
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO129041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics