Provider Demographics
NPI:1851315543
Name:COOKE, THOMAS E (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:COOKE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 GREEN RD
Mailing Address - Street 2:111
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2805
Mailing Address - Country:US
Mailing Address - Phone:919-872-1700
Mailing Address - Fax:919-850-3392
Practice Address - Street 1:4905 GREEN RD
Practice Address - Street 2:111
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2805
Practice Address - Country:US
Practice Address - Phone:919-872-1700
Practice Address - Fax:919-850-3392
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC58011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice