Individual
DR. JERRY M COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4710 AMBER VALLEY PARKWAY S, STE A, FARGO, ND 58104
(701) 232-1956
(701) 232-2226
Mailing address
4710 AMBER VALLEY PKWY S, STE A, FARGO, ND 58104
(701) 232-1956
(701) 232-2226
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1981
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
949321
BLUE CROSS BLUE SHIELD OF
ND
Enumeration date
01/04/2007
Last updated
07/10/2012
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