Organization
KATHRYN A. COOK,D.D.S.
Active
Other names
Kathryn A. Cook, D.D.S.
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA W THOMPSON (OFFICE MANAGER)
(434) 951-9215
Entity
Organization
Contact information
Practice address
895B RIO EAST CT, CHARLOTTESVILLE, VA 22901-8004
(434) 817-5437
(434) 817-5440
Mailing address
895B RIO EAST CT, CHARLOTTESVILLE, VA 22901-8004
(434) 817-5437
(434) 817-5440
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401007976
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18399
MEDICAID
VA
Enumeration date
07/07/2009
Last updated
07/07/2009
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