# FOX KIDS DENTISTRY & ORTHODONTICS II

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sprout Pediatric Dentistry & Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700374154
- **Authorized official:** DR. DANA FOX DMD (MANAGER)
- **Authorized official phone:** (503) 223-5039

## Contact information

- **Practice address:** 1401 SE MORRISON ST STE 120, PORTLAND, OR 97214-2777
- **Practice address phone:** (503) 477-9911
- **Mailing address:** 1401 SE MORRISON ST STE 120, PORTLAND, OR 97214-2777
- **Mailing address phone:** (503) 477-9911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 05/01/2018