Provider Demographics
NPI:1467483081
Name:COOK, JAMES HANK (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HANK
Last Name:COOK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:HANK
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:615 SECOND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:GA
Mailing Address - Zip Code:31079
Mailing Address - Country:US
Mailing Address - Phone:229-365-0056
Mailing Address - Fax:229-365-7737
Practice Address - Street 1:615 SECOND AVENUE
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:GA
Practice Address - Zip Code:31079
Practice Address - Country:US
Practice Address - Phone:229-365-0056
Practice Address - Fax:229-365-7737
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0113921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice