Organization
LOREN S COOK DMD PLLC
Active
Other names
Lawrence J. Kyle DDS, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOREN S. COOK DMD (DENTIST/OWNER/PRESIDENT)
(540) 951-8383
Entity
Organization
Contact information
Practice address
611 S MAIN STREET, STE A, BLACKSBURG, VA 24060-5208
(540) 951-8383
(540) 953-5030
Mailing address
611 S MAIN STREET, STE A, BLACKSBURG, VA 24060-5208
(540) 951-8383
(540) 953-5030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
401006217
VA
1223G0001X
General Practice Dentistry
0401006217
VA
1223G0001X
General Practice Dentistry
Primary
0401412480
VA
1223G0001X
General Practice Dentistry
0401412653
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001494067
UNITED CONCORDIA
—
05
—
007820861
—
VA
05
—
01321
—
VA
01
—
013321
DORAL DENTAL
VA
01
—
0494067
UNITED CONCORDIA
VA
01
—
229986
ANTHEM BLUE CROSS BLUE SH
VA
01
—
6217
DELTA DENTAL
VA
05
—
9220900
—
VA
05
—
9225146
—
VA
Enumeration date
07/26/2006
Last updated
12/23/2011
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