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General NPI Number Information
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NPI Number | 1669106548
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Entity Type | Individual
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Provider Name | CANDACE REBEKAH COOK DMD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 164 BLUFFTON RD
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City | BLUFFTON
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State | SC
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Zip | 29910-6248
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Country | US
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Telephone | 843-815-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 17 7TH AVE
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City | BLUFFTON
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State | SC
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Zip | 29910-8702
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Country | US
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Telephone | 229-206-1726
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN122781
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | DN122781
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11192
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License Number State | SC
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