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General NPI Number Information
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NPI Number | 1548270093
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Entity Type | Individual
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Provider Name | MARY C. COOKE D.D.S., M.S.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 3392 SOLANO AVE.
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-255-4400
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Fax | 707-257-7444
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Provider Business Mailing Address
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Address Line | 3392 SOLANO AVE.
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-255-4400
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Fax | 707-257-7444
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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 | 50047
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License Number State | CA
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