Provider Demographics
NPI:1164503140
Name:HOWARD COUNTY ORAL AND MAXILLOFACIAL SURGEONS
Entity Type:Organization
Organization Name:HOWARD COUNTY ORAL AND MAXILLOFACIAL SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-868-2222
Mailing Address - Street 1:1970 W BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-6078
Mailing Address - Country:US
Mailing Address - Phone:765-868-2222
Mailing Address - Fax:765-868-8119
Practice Address - Street 1:1970 W BOULEVARD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-6078
Practice Address - Country:US
Practice Address - Phone:765-868-2222
Practice Address - Fax:765-868-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty