Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | D2652 | AZ |
NPI | 1275573362 |
---|---|
Provider Name | Dr. Vance Cox |
First Address | Mesa, AZ 85213-1683 |
Second Address | Phoenix, AZ 85012-1839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |