MEDICARE: COX AND MANEGOLD DENTISTRY

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	122300000X	Dentist

General Provider Information

NPI Number	:	1710333869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COX AND MANEGOLD DENTISTRY

Provider Business Mailing Address
First Line	:	9215 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-4178
Country	:	US
Telephone Number	:	513-777-5513
Fax Number	:	513-777-7157

Provider Business Practice Location Address
First Line	:	9215 CINCINNATI COLUMBUS RD
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-4178
Country	:	US
Telephone Number	:	513-777-5513
Fax Number	:	513-777-7157

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS M COX
Credential	:	DDS
Telephone Number	:	513-777-5513

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	05/09/2016

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