Provider Demographics
NPI:1104930064
Name:FOX, JOSEPH ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:FOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 BUSINESS PARK CIR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3594
Mailing Address - Country:US
Mailing Address - Phone:615-859-3700
Mailing Address - Fax:615-859-6222
Practice Address - Street 1:3050 BUSINESS PARK CIR
Practice Address - Street 2:SUITE 202
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3594
Practice Address - Country:US
Practice Address - Phone:615-859-3700
Practice Address - Fax:615-859-6222
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0050231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice