MEDICARE: DR. THOMAS L COX D.D.S.,M.S.

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	1223P0221X	Pediatric Dentistry	0401007328	VA

General Provider Information

NPI Number	:	1104848266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS L COX D.D.S.,M.S.

Provider Business Mailing Address
First Line	:	3145 VIRGINIA BEACH BLVD
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-6950
Country	:	US
Telephone Number	:	757-340-2400
Fax Number	:	757-486-5471

Provider Business Practice Location Address
First Line	:	3145 VIRGINIA BEACH BLVD
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-6950
Country	:	US
Telephone Number	:	757-340-2400
Fax Number	:	757-486-5471

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/08/2007

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