Provider Demographics
NPI:1104156124
Name:COX, JESSICA HOLT (DDS,MSD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HOLT
Last Name:COX
Suffix:
Gender:F
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2631 MCINGVALE RD
Mailing Address - Street 2:SUITE 131
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-5934
Mailing Address - Country:US
Mailing Address - Phone:662-429-8022
Mailing Address - Fax:662-449-3175
Practice Address - Street 1:2631 MCINGVALE RD
Practice Address - Street 2:SUITE 131
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-5934
Practice Address - Country:US
Practice Address - Phone:662-429-8022
Practice Address - Fax:662-449-3175
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3510-091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics