Provider Demographics
NPI:1396150231
Name:COX, CHRISTINA MAYBERRY (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MAYBERRY
Last Name:COX
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:2050 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7958
Mailing Address - Country:US
Mailing Address - Phone:706-327-4513
Mailing Address - Fax:
Practice Address - Street 1:2050 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-327-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014794122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist