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General NPI Number Information
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NPI Number | 1538385414
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Entity Type | Individual
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Provider Name | KELLY ANN COOK DMD MS
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 8125 ARDREY KELL RD
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City | CHARLOTTE
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State | NC
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Zip | 28277
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Country | US
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Telephone | 704-540-3088
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Fax | 704-443-0011
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Provider Business Mailing Address
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Address Line | 8125 ARDREY KELL RD
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City | CHARLOTTE
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State | NC
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Zip | 28277
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Country | US
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Telephone | 704-540-3088
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Fax | 704-443-0011
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7362
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License Number State | NC
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