MEDICARE: DR. JOSHUA DARRELL ADCOX D.D.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	1223G0001X	General Practice Dentistry	61360	CA

General Provider Information

NPI Number	:	1609131366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA DARRELL ADCOX D.D.S

Provider Business Mailing Address
First Line	:	534 CREEKSIDE DR
Second Line	:
City	:	SALADO
State	:	TX
Zip	:	76571-5620
Country	:	US
Telephone Number	:	480-388-1661
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 SW H K DODGEN LOOP
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1849
Country	:	US
Telephone Number	:	480-388-1661
Fax Number	:

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

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	09/17/2016

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