Cook, Jerry M
Cook, Jerry M is an individual health care provider with primary practice located at 4710 Amber Valley Parkway S, Ste A , Fargo ND 58104. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Cook, Jerry M can be contacted via phone (701) 232-1956.Contact Information
Primary practice address
4710 Amber Valley Parkway S, Ste A
Fargo ND 58104
Phone: (701) 232-1956
Fax: (701) 232-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 1981 | North Dakota |
Profile Details
| NPI number | 1114074960 |
|---|---|
| LBN Legal business name | Cook, Jerry M |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2007 |
| Last updated | Jul 10th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114074960 | NPPES |
| North Dakota | Other | 949321 | BLUE CROSS BLUE SHIELD OF |
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