Provider Demographics
NPI:1174920110
Name:CHRISTY KENNA FOX, DDS, INC.
Entity type:Organization
Organization Name:CHRISTY KENNA FOX, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:KENNA
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-466-4700
Mailing Address - Street 1:RR 1 BOX 301F
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-9744
Mailing Address - Country:US
Mailing Address - Phone:304-466-3223
Mailing Address - Fax:304-466-4848
Practice Address - Street 1:606 STOKES DR
Practice Address - Street 2:SUITE B
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-2554
Practice Address - Country:US
Practice Address - Phone:304-466-4700
Practice Address - Fax:304-466-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3333261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental