Provider Demographics
NPI:1467431049
Name:COOK, TONYA X (DMD)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:X
Last Name:COOK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 KEARNY AVE
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4700
Mailing Address - Country:US
Mailing Address - Phone:732-293-0135
Mailing Address - Fax:732-293-0139
Practice Address - Street 1:149 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4700
Practice Address - Country:US
Practice Address - Phone:732-293-0135
Practice Address - Fax:732-293-0139
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ20369122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist