=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346307162
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | P STUART COX DDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4788 FINLAY ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23231-2754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-222-8140
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4788 FINLAY ST
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23231-2754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-222-8140
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRISIDENT
-----------------------------------------------------
Name | DR. P STUART COX
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 804-222-8140
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 0401004993
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------