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General NPI Number Information
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NPI Number | 1205934973
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Entity Type | Individual
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Provider Name | FRIEDA COOKE DDS
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 6355 ROCKVILLE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-3920
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Country | US
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Telephone | 317-227-0581
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Fax | 317-227-0820
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Provider Business Mailing Address
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Address Line | 6355 ROCKVILLE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-3920
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Country | US
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Telephone | 317-227-0581
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Fax | 317-227-0820
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12009952
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License Number State | IN
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