Provider Demographics
NPI:1013300193
Name:WILLIAM COX DENTAL CORPORATION
Entity Type:Organization
Organization Name:WILLIAM COX DENTAL CORPORATION
Other - Org Name:GENTLE DENTAL BRENTWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PC OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:800-684-6440
Mailing Address - Street 1:9800 S LA CIENEGA BLVD
Mailing Address - Street 2:STE 899, ROOM 1
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4440
Mailing Address - Country:US
Mailing Address - Phone:800-684-6440
Mailing Address - Fax:360-449-5715
Practice Address - Street 1:3150 BALFOUR RD
Practice Address - Street 2:STE C
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5519
Practice Address - Country:US
Practice Address - Phone:925-392-4065
Practice Address - Fax:925-634-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty