| Fox Professional Dental Corporation | |
|
1235 W Vista Way Ste K Vista CA 92083 | |
| (760) 631-0007 | |
| (760) 631-0009 |
| Full Name | Fox Professional Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1235 W Vista Way Ste K, Vista, California |
| Authorized Official Name and Position | Ethan G Fox (EXECUTIVE OFFICER) |
| Authorized Official Contact | 8582483359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox Professional Dental Corporation 1235 W Vista Way Ste K Vista CA 92083 Ph: (760) 631-0007 | Fox Professional Dental Corporation 1235 W Vista Way Ste K Vista CA 92083 Ph: (760) 631-0007 |
| NPI Number | 1598939183 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598939183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 52857 (California) | Primary |
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