Provider Demographics
NPI:1629216270
Name:COOK, DEANA CLARE (DDS)
Entity Type:Individual
Prefix:
First Name:DEANA
Middle Name:CLARE
Last Name:COOK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3655
Mailing Address - Country:US
Mailing Address - Phone:910-256-8486
Mailing Address - Fax:910-256-8449
Practice Address - Street 1:7028 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3655
Practice Address - Country:US
Practice Address - Phone:910-256-8486
Practice Address - Fax:910-256-8449
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics