Provider Demographics
NPI:1568516292
Name:COOKE, WILLIAM NEWPORT (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NEWPORT
Last Name:COOKE
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 1:1618 RIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5316
Mailing Address - Country:US
Mailing Address - Phone:850-878-6523
Mailing Address - Fax:850-877-8346
Practice Address - Street 1:1618 RIGGINS RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5316
Practice Address - Country:US
Practice Address - Phone:850-878-6523
Practice Address - Fax:850-877-8346
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4546122300000X
FLDN 16673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist