Provider Demographics
NPI:1710020532
Name:COX, PAUL C (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:COX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:64683-1751
Mailing Address - Country:US
Mailing Address - Phone:660-359-6889
Mailing Address - Fax:660-359-3738
Practice Address - Street 1:1011 CEDAR ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MO
Practice Address - Zip Code:64683-1751
Practice Address - Country:US
Practice Address - Phone:660-359-6889
Practice Address - Fax:660-359-3738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO145461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice