MEDICARE: LEWIS E COOK DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DD2878	NM

General Provider Information

NPI Number	:	1154512648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEWIS E COOK DDS

Provider Business Mailing Address
First Line	:	8151 E INDIAN BEND RD
Second Line	:	STE 111
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85250-4826
Country	:	US
Telephone Number	:	480-607-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 N ZARAGOZA RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7905
Country	:	US
Telephone Number	:	915-855-4442
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	06/06/2012

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Directions to “ LEWIS E COOK DDS” Practice Location

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