Individual
MS. JOANNA M FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
192 WESTERN AVE, PORTLAND, ME 04106-2428
(207) 773-1703
Mailing address
48 REVERE ST, PORTLAND, ME 04103-4010
(207) 205-4396
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4308
ME
Other
Enumeration date
06/13/2013
Last updated
01/02/2014
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