MEDICARE: DR. STANLEY COVINGTON COX JR. D.M.D., 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN013191	GA

General Provider Information

NPI Number	:	1134395353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STANLEY COVINGTON COX JR. D.M.D., M.S.

Provider Business Mailing Address
First Line	:	1627 TRYON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-2942
Country	:	US
Telephone Number	:	678-580-2286
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 TOWN BLVD NE
Second Line	:	SUITE A2000
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-3147
Country	:	US
Telephone Number	:	404-343-0677
Fax Number	:	404-343-0934

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

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	10/27/2015

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