Dr. Jerry M Cook
Endodontist
4710 Amber Valley Parkway S, Ste A
Fargo
, North Dakota 58104
Dr. Jerry M Cook
Endodontist
4710 Amber Valley Parkway S, Ste A
Fargo
, North Dakota 58104
(701) 232-2226
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Jerry M Cook
- 4710 Amber Valley Pkwy S, Ste A
- Fargo, ND
- Zip : 58104
- Fax : (701) 232-2226
- Phone : (701) 232-1956
Second Address
- Dr. Jerry M Cook
- 4710 Amber Valley Parkway S, Ste A
- Fargo, ND
- Zip : 58104
- Fax : (701) 232-2226
- Phone : (701) 232-1956
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 1981 | ND |
National Provider Identifier
| NPI | 1114074960 |
|---|---|
| Provider Name | Dr. Jerry M Cook |
| First Address | Fargo, ND 58104 |
| Second Address | Fargo, ND 58104 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2007 |
| Last Update Date | 10/07/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 949321 | BLUE CROSS BLUE SHIELD OF (01) | ND |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.