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General NPI Number Information
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NPI Number | 1497176853
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Entity Type | Organization
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Legal Business Name | CHARLES G COX JR DMD PA
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Dates
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Enumeration Date | 01/02/2014
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 216 N MAIN ST STE B
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City | TRENTON
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State | FL
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Zip | 32693-3427
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Country | US
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Telephone | 352-463-2665
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Fax | 352-463-6848
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Provider Business Mailing Address
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Address Line | 216 N MAIN ST STE B
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City | TRENTON
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State | FL
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Zip | 32693-3427
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Country | US
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Telephone | 352-463-2665
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Fax | 352-463-6848
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Authorized Official
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Title or Position | PRESIDENT/OWQNER
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Name | DR. CHARLES G COX JR.
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Credential | DMD
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Telephone | 352-463-2665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN8041
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License Number State | FL
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