Individual
DR. NORMAN BLAINE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(317) 274-5328
Mailing address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(317) 274-5328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009644A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7874
BC/BS
NE
Enumeration date
09/30/2005
Last updated
09/11/2009
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