Provider Demographics
NPI:1760499453
Name:COX, GAYLE SEVIER JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:SEVIER
Last Name:COX
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BROYLES DR
Mailing Address - Street 2:STE 302
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601
Mailing Address - Country:US
Mailing Address - Phone:423-282-1562
Mailing Address - Fax:423-282-1552
Practice Address - Street 1:203 BROYLES DR
Practice Address - Street 2:STE 302
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601
Practice Address - Country:US
Practice Address - Phone:423-282-1562
Practice Address - Fax:423-282-1552
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS27011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice