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Organization

PRUDEN FAMILY DENTISTRY

Active
Parent organization
P MILTON COOK PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
P MILTON COOK PC
Authorized official
DONNA RENEE JOHNSON (GENERAL MANAGER)
(757) 357-4121
Entity
Organization

Contact information

Practice address
2303 PRUDEN BLVD, SUFFOLK, VA 23434-4330
(757) 539-9481
Mailing address
2303 PRUDEN BLVD, SUFFOLK, VA 23434-4330
(757) 539-9481

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/01/2021
Last updated
12/01/2021
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