Individual
DR. HENRY WILLIAM COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
142 GATEWAY DR, BRANDON, MS 39042-3085
(601) 824-1950
(601) 824-1953
Mailing address
142 GATEWAY DR, BRANDON, MS 39042-3085
(601) 824-1950
(601) 824-1953
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2716-93
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660112
—
MS
01
—
2716-93
DENTAL LICENSE NUMBER
MS
Enumeration date
10/26/2006
Last updated
07/09/2007
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