Provider Demographics
NPI:1740306133
Name:COOK, DANIEL STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
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 1:195 N THOMPSON AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-9029
Mailing Address - Country:US
Mailing Address - Phone:805-929-5000
Mailing Address - Fax:805-929-5900
Practice Address - Street 1:195 N THOMPSON AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NIPOMO
Practice Address - State:CA
Practice Address - Zip Code:93444-9029
Practice Address - Country:US
Practice Address - Phone:805-929-5000
Practice Address - Fax:805-929-5900
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27113122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist