Provider Demographics
NPI:1124091608
Name:FOX, GERALD DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:DAVID
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 1:7171 W CRAIG RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6018
Mailing Address - Country:US
Mailing Address - Phone:702-655-0331
Mailing Address - Fax:702-655-0377
Practice Address - Street 1:7171 W CRAIG RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6018
Practice Address - Country:US
Practice Address - Phone:718-761-5600
Practice Address - Fax:718-761-7966
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0294921223G0001X
NV60451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice