Provider Demographics
NPI:1588786560
Name:SILCOX, JAY W (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:W
Last Name:SILCOX
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1291 W 12600 S
Mailing Address - Street 2:SUITE #104
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-7098
Mailing Address - Country:US
Mailing Address - Phone:801-254-4161
Mailing Address - Fax:801-253-1646
Practice Address - Street 1:1291 W 12600 S
Practice Address - Street 2:SUITE #104
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7098
Practice Address - Country:US
Practice Address - Phone:801-254-4161
Practice Address - Fax:801-253-1646
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT136802-9922, 89031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice