Provider Demographics
NPI:1831426196
Name:DAVID J. FOX, D.M.D., P.C.
Entity type:Organization
Organization Name:DAVID J. FOX, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-481-0441
Mailing Address - Street 1:PO BOX 624
Mailing Address - Street 2:
Mailing Address - City:FOXCROFT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19046-7024
Mailing Address - Country:US
Mailing Address - Phone:215-481-0441
Mailing Address - Fax:
Practice Address - Street 1:2401 PENNSYLVANIA AVE STE 1A8
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3002
Practice Address - Country:US
Practice Address - Phone:215-481-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS-022175LOtherPENNSYLVANIA DEPARTMENT OF STATE - BOARD OF DENTISTRY