Provider Demographics
NPI:1952509333
Name:COX, WALTER W (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:W
Last Name:COX
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 S ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-0300
Mailing Address - Country:US
Mailing Address - Phone:605-226-3636
Mailing Address - Fax:605-226-2790
Practice Address - Street 1:708 S ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-0300
Practice Address - Country:US
Practice Address - Phone:605-226-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM8831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics