Cooke, Jason William

Cooke, Jason William is an sole proprietor health care provider with primary practice located at 2557B E Calumet St , Appleton WI 54915-4748. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Cooke, Jason William can be contacted via phone (920) 733-7770.

Contact Information

Primary practice address
2557B E Calumet St Appleton WI 54915-4748
Phone: (920) 733-7770
Fax: (920) 733-7798
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 5864-015 Wisconsin

Profile Details

NPI number 1558662387
LBN Legal business name Cooke, Jason William
Credentials DDS,MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2010
Last updated Nov 10th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558662387 NPPES
Wisconsin Other 1134339500 ORGANIZATION NPI

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