Individual
VICTOR D COOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7910 USTICK RD, BOISE, ID 83704-5850
(208) 322-5522
Mailing address
7910 USTICK RD, BOISE, ID 83704-5850
(208) 322-5522
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D1550-05
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1550-05
STATE LICENSE #
ID
Enumeration date
05/26/2006
Last updated
07/08/2007
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