Provider Demographics
NPI:1528021672
Name:COKE, CHRISTINE JEANETTE (DDS,MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:JEANETTE
Last Name:COKE
Suffix:
Gender:F
Credentials:DDS,MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:107 SUNCREEK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2833
Mailing Address - Country:US
Mailing Address - Phone:214-383-1380
Mailing Address - Fax:214-383-1379
Practice Address - Street 1:107 SUNCREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2833
Practice Address - Country:US
Practice Address - Phone:214-383-1380
Practice Address - Fax:214-383-1379
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX187821223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX78885Medicare UPIN