Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DS040233 | PA |
Y | 1223P0221X | Pediatric Dentist | 64478 | CA |
NPI | 1053709782 |
---|---|
Provider Name | Hayley Cox |
First Address | Encinitas, CA 92024 |
Second Address | San Marcos, CA 92069-3513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 17/03/2018 |