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Organization

KEVIN COOK ORTHODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL KEVIN COOK DDS, MS (DOCTOR/ OWNER)
(618) 997-6640
Entity
Organization

Contact information

Practice address
3108 W. DEYOUNG ST., SUITE A, MARION, IL 62959-5548
(618) 997-6640
(618) 997-6641
Mailing address
3108 W. DEYOUNG ST., SUITE A, MARION, IL 62959-5548
(618) 997-6640
(618) 997-6641

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002209
IL

Other

Enumeration date
10/21/2014
Last updated
04/05/2016
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