MEDICARE: BEVERLY B. COZORT, D.D.S., P.A.

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	1223G0001X	General Practice Dentistry	4474	NC

General Provider Information

NPI Number	:	1780896464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY B. COZORT, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	105 BIMINI CT
Second Line	:
City	:	HAVELOCK
State	:	NC
Zip	:	28532-8994
Country	:	US
Telephone Number	:	252-444-2494
Fax Number	:	252-444-2494

Provider Business Practice Location Address
First Line	:	218 PROFESSIONAL CIR
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4302
Country	:	US
Telephone Number	:	252-726-2360
Fax Number	:	252-726-2072

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BEVERLY B. COZORT
Credential	:	D.D.S.
Telephone Number	:	252-444-2494

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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