MEDICARE: DR. DUANE EDWARD COX D.M.D.

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	DN008572	GA

General Provider Information

NPI Number	:	1801053129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUANE EDWARD COX D.M.D.

Provider Business Mailing Address
First Line	:	486 LONG BRANCH RD
Second Line	:
City	:	TEMPLE
State	:	GA
Zip	:	30179-4012
Country	:	US
Telephone Number	:	678-850-5682
Fax Number	:

Provider Business Practice Location Address
First Line	:	486 LONG BRANCH RD
Second Line	:
City	:	TEMPLE
State	:	GA
Zip	:	30179-4012
Country	:	US
Telephone Number	:	678-850-5682
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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