Individual
DR. LEAH M COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
112 S MAIN ST, FITZGERALD, GA 31750-2945
(229) 423-4500
(229) 423-3562
Mailing address
PO BOX 5510, FITZGERALD, GA 31750-5510
(229) 423-4500
(229) 423-3562
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011597
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000717505A
—
GA
Enumeration date
07/12/2006
Last updated
08/19/2024
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