Provider Demographics
NPI:1780715060
Name:COX, CATHERINE JEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JEAN
Last Name:COX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LAS GALLINAS AVE
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3438
Mailing Address - Country:US
Mailing Address - Phone:415-479-2623
Mailing Address - Fax:415-479-1288
Practice Address - Street 1:750 LAS GALLINAS AVE
Practice Address - Street 2:SUITE 217
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3438
Practice Address - Country:US
Practice Address - Phone:415-479-2623
Practice Address - Fax:415-479-1288
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA346031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice