Provider Demographics
NPI:1801053129
Name:COX, DUANE EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:EDWARD
Last Name:COX
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 LONG BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:GA
Mailing Address - Zip Code:30179-4012
Mailing Address - Country:US
Mailing Address - Phone:678-850-5682
Mailing Address - Fax:
Practice Address - Street 1:486 LONG BRANCH RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:GA
Practice Address - Zip Code:30179-4012
Practice Address - Country:US
Practice Address - Phone:678-850-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist