MEDICARE: DR. TAMMY L COOK DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3775	ME

General Provider Information

NPI Number	:	1346380722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY L COOK DMD

Provider Business Mailing Address
First Line	:	304 WASHINGTON ST
Second Line	:
City	:	BATH
State	:	ME
Zip	:	04530-1641
Country	:	US
Telephone Number	:	207-442-7581
Fax Number	:	207-442-7531

Provider Business Practice Location Address
First Line	:	304 WASHINGTON ST
Second Line	:
City	:	BATH
State	:	ME
Zip	:	04530-1641
Country	:	US
Telephone Number	:	207-442-7581
Fax Number	:	207-442-7531

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	02/03/2016

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Directions to “ DR. TAMMY L COOK DMD” Practice Location

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