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Organization

MOSES LAKE PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STANLEY HAMILTON COX DMD, PS (OWNER)
(509) 765-2255
Entity
Organization

Contact information

Practice address
800 N STRATFORD RD, MOSES LAKE, WA 98837-1512
(509) 765-2255
(509) 765-1155
Mailing address
800 N STRATFORD RD, MOSES LAKE, WA 98837-1512
(509) 765-2255
(509) 765-1155

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DE60331610
WA
1223P0221X
Pediatric Dentistry
Primary
DE60331610
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2050514
WA
Enumeration date
05/19/2016
Last updated
05/19/2016
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