Provider Demographics
NPI:1255418042
Name:COOK, CHRISTINE SUE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SUE
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 1:877 W FREMONT AVE
Mailing Address - Street 2:SUITE L-1
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2315
Mailing Address - Country:US
Mailing Address - Phone:408-738-4783
Mailing Address - Fax:
Practice Address - Street 1:877 W FREMONT AVE
Practice Address - Street 2:SUITE L-1
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2315
Practice Address - Country:US
Practice Address - Phone:408-738-4783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297081223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics