Organization
DEANA C COOK, DDS, MS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEANA CLARE COOK DDS, MS (PERIODONTIST)
(910) 256-8486
Entity
Organization
Contact information
Practice address
7028 WRIGHTSVILLE AVE, WILMINGTON, NC 28403-3655
(910) 256-8486
Mailing address
7028 WRIGHTSVILLE AVE, WILMINGTON, NC 28403-3655
(910) 256-8486
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8760
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14314023100671
MEDICARE ORDERING AND REFERRING
NC
Enumeration date
07/01/2014
Last updated
10/06/2015
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