Provider Demographics
NPI:1922197599
Name:COX, DAVID EDWARD (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
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 1:2510 HULMAN
Mailing Address - Street 2:DAVID E COX DDS
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803
Mailing Address - Country:US
Mailing Address - Phone:812-232-2445
Mailing Address - Fax:812-232-2445
Practice Address - Street 1:2510 HULMAN ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803
Practice Address - Country:US
Practice Address - Phone:812-232-2445
Practice Address - Fax:812-232-2445
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-03-23
Deactivation Date:2008-08-19
Deactivation Code:
Reactivation Date:2012-03-23
Provider Licenses
StateLicense IDTaxonomies
IN6930122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100250110AMedicaid