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General NPI Number Information
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NPI Number | 1730342676
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Entity Type | Individual
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Provider Name | JEREMIAH BOND COOK D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 5858 W MAIN ST SUITE 260
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City | FRISCO
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State | TX
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Zip | 75033-4193
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Country | US
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Telephone | 469-888-4315
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Fax |
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Provider Business Mailing Address
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Address Line | 5858 W MAIN ST SUITE 260
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City | FRISCO
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State | TX
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Zip | 75033-4193
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Country | US
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Telephone | 469-888-4315
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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 | 0023833
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 23833
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License Number State | TX
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