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NPI Code Detail

MEDICARE: COX DENTAL COPRPORATION

MEDICARE: COX DENTAL COPRPORATION
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
11223G0001XGeneral Practice Dentistry26160CA

General Provider Information

NPI Number : 1821205493
Entity Type Code : Organization
Provider Name (Legal Business Name) : COX DENTAL COPRPORATION
Provider Business Mailing Address
First Line : 1101 SE TECH CENTER DRIVE
Second Line : STE 195
City : VANCOUVER
State : WA
Zip : 98683-5511
Country : US
Telephone Number : 800-684-6440
Fax Number : 877-725-7443
Provider Business Practice Location Address
First Line : 12800 HEACOCK ST
Second Line : STE A-1
City : MORENO VALLEY
State : CA
Zip : 92553-2868
Country : US
Telephone Number : 951-247-2688
Fax Number : 951-247-3142
Authorized Official
Title or Position : PRESIDENT
Name : DR. WILLIAM J COX
Credential : DDS
Telephone Number : 800-684-6440
Provider Enumeration Date : 05/16/2007
Last Update Date : 01/08/2020

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Directions to “COX DENTAL COPRPORATION ” Practice Location

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