Provider Demographics
NPI:1730277187
Name:CAYCE, JOHN CARRELL (DENTIST DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CARRELL
Last Name:CAYCE
Suffix:
Gender:M
Credentials:DENTIST DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75672
Mailing Address - Country:US
Mailing Address - Phone:903-935-5132
Mailing Address - Fax:
Practice Address - Street 1:2302 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75672
Practice Address - Country:US
Practice Address - Phone:903-935-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD16413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist