Individual
DR. STEPHEN A COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MSD
Contact information
Practice address
2114 SCOTT ST, LAFAYETTE, IN 47904-2932
(765) 448-1539
(765) 447-6388
Mailing address
2114 SCOTT ST, LAFAYETTE, IN 47904-2932
(765) 448-1539
(765) 447-6388
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
12007594
IN
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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