Provider Demographics
NPI:1649471665
Name:ROOKE, DANIEL PAUL (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:ROOKE
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:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-0520
Mailing Address - Country:US
Mailing Address - Phone:541-929-3239
Mailing Address - Fax:541-929-6978
Practice Address - Street 1:1224 APPLEGATE ST
Practice Address - Street 2:
Practice Address - City:PHILOMATH
Practice Address - State:OR
Practice Address - Zip Code:97370-0000
Practice Address - Country:US
Practice Address - Phone:541-929-3239
Practice Address - Fax:541-929-6978
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist