Provider Demographics
NPI:1891224747
Name:CHARLES G COX JR DMD OF HIGH SPRINGS PLLC
Entity Type:Organization
Organization Name:CHARLES G COX JR DMD OF HIGH SPRINGS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:GREEN
Authorized Official - Last Name:COX
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:386-454-2665
Mailing Address - Street 1:23321 NW COUNTY ROAD 236
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-9669
Mailing Address - Country:US
Mailing Address - Phone:386-454-2665
Mailing Address - Fax:386-454-4039
Practice Address - Street 1:23321 NW COUNTY ROAD 236
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-9669
Practice Address - Country:US
Practice Address - Phone:386-454-2665
Practice Address - Fax:386-454-4039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL8041122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty