Individual
GARY STEWART COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
490 E POWELL BLVD, GRESHAM, OR 97030-7610
(503) 665-6166
(503) 661-7236
Mailing address
490 E POWELL BLVD, GRESHAM, OR 97030-7610
(503) 665-6166
(503) 661-7236
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4712
OR
Other
Enumeration date
06/24/2007
Last updated
07/08/2007
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