Organization
BEACH DENTAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK A FOX DENTIS (PRES)
(386) 428-6491
Entity
Organization
Contact information
Practice address
34 DORMER DR, ORMOND BEACH, FL 32174-1051
(386) 428-6491
Mailing address
809 STATE ROAD 44, NEW SMYRNA BEACH, FL 32168-7271
(386) 428-6491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15016
FL
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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