Individual
JERRY WAYNE COOK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
715 CALVIN AVERY DRIVE, WEST MEMPHIS, AR 72301
(870) 735-3601
(870) 732-9535
Mailing address
303 BANCARIO STE 7, MARION, AR 72364-2826
(870) 739-8799
(870) 739-8799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3113
AR
Other
Enumeration date
10/12/2006
Last updated
11/01/2022
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