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Individual
JONATHAN TODD COOK
Active
Individual
JONATHAN TODD COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7453
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275610495
BUSINESS NPI #
OR
Enumeration date
10/19/2008
Last updated
10/19/2008
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