Individual
MR. KELLY JORN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3800 W RAY RD STE 19, CHANDLER, AZ 85226-5940
(480) 899-4477
(480) 857-9027
Mailing address
3800 W RAY RD STE 19, CHANDLER, AZ 85226-5940
(480) 899-4477
(480) 857-9027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4037
AZ
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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