MEDICARE: MICHAEL L. FOX D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2273	AR

General Provider Information

NPI Number	:	1164623070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL L. FOX D.D.S.

Provider Business Mailing Address
First Line	:	2504 MCCAIN BLVD
Second Line	:	SUITE 200
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7607
Country	:	US
Telephone Number	:	501-753-9781
Fax Number	:	501-753-9789

Provider Business Practice Location Address
First Line	:	2504 MCCAIN BLVD
Second Line	:	SUITE 200
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7607
Country	:	US
Telephone Number	:	501-753-9781
Fax Number	:	501-753-9789

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MICHAEL L. FOX
Credential	:	DDS
Telephone Number	:	501-753-9781

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	08/22/2020

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