Individual
DR. MATTHEW WAYNE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
437 BAUSKETT ST, EDGEFIELD, SC 29824-4501
(803) 637-4616
Mailing address
PO BOX 330, EDGEFIELD, SC 29824-0330
(803) 637-4616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.4708 GD
SC
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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