Provider Demographics
NPI:1073249389
Name:ARCHIE COOK JR DDS II PLLC
Entity Type:Organization
Organization Name:ARCHIE COOK JR DDS II PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEORGE-PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-803-0168
Mailing Address - Street 1:251 KEISLER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7091
Mailing Address - Country:US
Mailing Address - Phone:919-803-0168
Mailing Address - Fax:984-200-6289
Practice Address - Street 1:1398 KILDAIRE FARM RD STE 300
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5567
Practice Address - Country:US
Practice Address - Phone:919-481-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty