Provider Demographics
NPI:1578858643
Name:DAVID A. COOK, DDS, PA
Entity Type:Organization
Organization Name:DAVID A. COOK, DDS, PA
Other - Org Name:SMILES AT FRANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:612-824-7033
Mailing Address - Street 1:4999 FRANCE AVE S
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410
Mailing Address - Country:US
Mailing Address - Phone:612-824-7033
Mailing Address - Fax:612-285-5438
Practice Address - Street 1:4999 FRANCE AVE S
Practice Address - Street 2:SUITE 230
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410
Practice Address - Country:US
Practice Address - Phone:612-824-7033
Practice Address - Fax:612-285-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND93211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty