Provider Demographics
NPI:1932752599
Name:DOXEY, MAXWELL SCOTT (DMD)
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:SCOTT
Last Name:DOXEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 QUINN DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-2912
Mailing Address - Country:US
Mailing Address - Phone:801-949-1526
Mailing Address - Fax:
Practice Address - Street 1:1445 N 400 E # 3A
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7564
Practice Address - Country:US
Practice Address - Phone:435-752-1699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12883627122300000X
NV7212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty