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General NPI Number Information
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NPI Number | 1306931589
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Entity Type | Organization
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Legal Business Name | RODERICK S FOX DDS
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 UNIVERSITY BLVD S
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City | MOBILE
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State | AL
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Zip | 36609-2958
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Country | US
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Telephone | 251-342-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 UNIVERSITY BLVD
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City | MOBILE
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State | AL
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Zip | 36609-2958
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Country | US
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Telephone | 251-342-5636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODERICK STEPHEN FOX
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Credential | DDS
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Telephone | 251-342-5636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AL3416
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License Number State | AL
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