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General NPI Number Information
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NPI Number | 1588196596
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Entity Type | Organization
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Legal Business Name | MICHAEL R. COX D.D.S. P.L.L.C.
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 3705 EMERSON AVE.
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City | PARKERSBURG
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State | WV
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Zip | 26104
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Country | US
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Telephone | 304-485-7717
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Fax | 304-428-4755
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Provider Business Mailing Address
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Address Line | 3705 EMERSON AVE
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City | PARKERSBURG
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State | WV
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Zip | 26104-1118
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Country | US
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Telephone | 304-485-7717
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Fax | 304-428-4755
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS STEFANIE PHILLENA GROGG
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Credential |
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Telephone | 304-485-7717
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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 | 4123
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License Number State | WV
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