Individual
JEREMIAH EUGENE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3516 BUSINESS 27, BUCHANAN, GA 30113-4813
(770) 646-8294
Mailing address
2582 OLD ROSWELL RD SE UNIT B, SMYRNA, GA 30080-2112
(770) 712-9062
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123109
GA
Other
Enumeration date
06/27/2023
Last updated
07/11/2023
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