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Organization
SUGARLAND DENTAL PC
Active
Organization
SUGARLAND DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN JEFFREY COOK DDS (PRESIDENT SUGARLAND DENTAL PC)
(307) 673-5522
Entity
Organization
Contact information
Practice address
941A SUGARLAND DRIVE, SHERIDAN, WY 82801
(307) 673-5522
(307) 673-0658
Mailing address
941A SUGARLAND DRIVE, SHERIDAN, WY 82801
(307) 673-5522
(307) 673-0658
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1017
AK
1223G0001X
General Practice Dentistry
Primary
1030
WY
1223G0001X
General Practice Dentistry
6291
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120907800
—
WY
Enumeration date
09/01/2006
Last updated
04/26/2016
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