MEDICARE: AARON M. COOK, DMD, LLC

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	1223G0001X	General Practice Dentistry	5397	AL

General Provider Information

NPI Number	:	1790816239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AARON M. COOK, DMD, LLC

Provider Business Mailing Address
First Line	:	PO BOX 170163
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35217-0163
Country	:	US
Telephone Number	:	205-849-0676
Fax Number	:	205-849-9533

Provider Business Practice Location Address
First Line	:	1710 JACKSON BLVD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35217-2432
Country	:	US
Telephone Number	:	205-849-0676
Fax Number	:	205-849-9533

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AARON MATTHEW COOK
Credential	:	DMD
Telephone Number	:	205-849-0676

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/22/2020

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