Provider Demographics
NPI:1326165978
Name:COOK, THOMAS BOWERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BOWERS
Last Name:COOK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 POND RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:ME
Mailing Address - Zip Code:04284-3114
Mailing Address - Country:US
Mailing Address - Phone:207-685-4648
Mailing Address - Fax:207-685-3748
Practice Address - Street 1:45 FULLER RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-4910
Practice Address - Country:US
Practice Address - Phone:207-623-3116
Practice Address - Fax:207-622-7834
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME25451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics