Provider Demographics
NPI:1497312649
Name:COOK, CHRISTIAN G (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:G
Last Name:COOK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 WRIGHTSVILLE AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7273
Mailing Address - Country:US
Mailing Address - Phone:910-726-9888
Mailing Address - Fax:
Practice Address - Street 1:7205 WRIGHTSVILLE AVE STE 105
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7273
Practice Address - Country:US
Practice Address - Phone:910-726-9888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice