Provider Demographics
NPI:1740354901
Name:COOK, BRUCE CHRISTOPHER (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:CHRISTOPHER
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 1:3300 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2818
Mailing Address - Country:US
Mailing Address - Phone:804-359-2136
Mailing Address - Fax:804-359-8300
Practice Address - Street 1:3300 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2818
Practice Address - Country:US
Practice Address - Phone:804-359-2136
Practice Address - Fax:804-359-8300
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA051531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice