Individual
DR. RONNIE LYNN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
7701 E BROADWAY BLVD, TUCSON, AZ 85710-3941
(760) 322-0264
Mailing address
2733 TUMBLE BROOK DR, LAS VEGAS, NV 89134-7853
(928) 412-7711
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
102243
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1687
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619182375
DENTAL
—
01
—
2001687
DELTA DENTAL
AZ
01
—
815058
UNITED CONCORDIA
AZ
01
—
AZ0498810
BCBS
AZ
Enumeration date
05/14/2007
Last updated
06/01/2021
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