Provider Demographics
NPI:1902466048
Name:COOK DENTISTRY PLLC
Entity Type:Organization
Organization Name:COOK DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-402-9090
Mailing Address - Street 1:3315 RANCH ROAD 620 S STE 250
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6873
Mailing Address - Country:US
Mailing Address - Phone:512-402-9090
Mailing Address - Fax:512-402-9091
Practice Address - Street 1:3315 RANCH ROAD 620 S STE 250
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-6873
Practice Address - Country:US
Practice Address - Phone:512-402-9090
Practice Address - Fax:512-402-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental