Provider Demographics
NPI:1700950698
Name:COOK, LORIN (DDS)
Entity Type:Individual
Prefix:
First Name:LORIN
Middle Name:
Last Name:COOK
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 1:301 ALAMO DR
Mailing Address - Street 2:SUITE A1
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-4246
Mailing Address - Country:US
Mailing Address - Phone:707-474-9621
Mailing Address - Fax:707-474-9061
Practice Address - Street 1:301 ALAMO DR
Practice Address - Street 2:SUITE A1
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4246
Practice Address - Country:US
Practice Address - Phone:707-474-9621
Practice Address - Fax:707-474-9061
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice