# SUGARLAND DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922110147
- **Authorized official:** BRIAN JEFFREY COOK DDS (PRESIDENT SUGARLAND DENTAL PC)
- **Authorized official phone:** (307) 673-5522

## Contact information

- **Practice address:** 941A SUGARLAND DRIVE, SHERIDAN, WY 82801
- **Practice address phone:** (307) 673-5522
- **Practice address fax:** (307) 673-0658
- **Mailing address:** 941A SUGARLAND DRIVE, SHERIDAN, WY 82801
- **Mailing address phone:** (307) 673-5522
- **Mailing address fax:** (307) 673-0658

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1017 | AK | — |
| 1223G0001X | General Practice Dentistry | 1030 | WY | Yes |
| 1223G0001X | General Practice Dentistry | 6291 | NC | — |

## Other

- **Enumeration date:** 09/01/2006
- **Last updated:** 04/26/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 120907800 | — | WY |