Provider Demographics
NPI:1992889513
Name:FOX, MICHAEL L (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
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 1:2504 MCCAIN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7612
Mailing Address - Country:US
Mailing Address - Phone:501-753-9781
Mailing Address - Fax:501-753-9789
Practice Address - Street 1:2504 MCCAIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7612
Practice Address - Country:US
Practice Address - Phone:501-753-9781
Practice Address - Fax:501-753-9789
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist