Provider Demographics
NPI:1770368862
Name:HANNAH FOX DENTAL CORPORATION
Entity type:Organization
Organization Name:HANNAH FOX DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:KRISTINA
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-544-2251
Mailing Address - Street 1:325 ELEFA ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-1532
Mailing Address - Country:US
Mailing Address - Phone:916-544-2251
Mailing Address - Fax:
Practice Address - Street 1:10 SIERRA GATE PLZ STE 170
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6646
Practice Address - Country:US
Practice Address - Phone:916-544-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental