Provider Demographics
NPI:1013120310
Name:WILLOX, ANGELA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:WILLOX
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 1:2930 MAGUIRE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4750
Mailing Address - Country:US
Mailing Address - Phone:407-984-4890
Mailing Address - Fax:
Practice Address - Street 1:2930 MAGUIRE RD STE 100
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4750
Practice Address - Country:US
Practice Address - Phone:407-984-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2019-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN222691223P0221X, 1223P0221X
GADN0147531223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry