Individual
JONATHAN TODD COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 MOLALLA AVE, SUITE 110, OREGON CITY, OR 97045-3788
(503) 656-8287
(503) 656-8375
Mailing address
1001 MOLALLA AVE, SUITE 110, OREGON CITY, OR 97045-3788
(503) 656-8287
(503) 656-8375
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7453
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275610495
BUSINESS NPI #
OR
Enumeration date
10/19/2008
Last updated
10/19/2008
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