MEDICARE: TAYLOR COOK DDS PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1922770783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR COOK DDS PLLC

Provider Business Mailing Address
First Line	:	7550 W 23RD AVE
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80214-5725
Country	:	US
Telephone Number	:	304-813-7138
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 N LINCOLN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-3400
Country	:	US
Telephone Number	:	720-440-9598
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TAYLOR COOK
Credential	:	DDS
Telephone Number	:	304-813-7138

Provider Enumeration Date	:	09/30/2021
Last Update Date	:	09/30/2021

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