Provider Demographics
NPI:1861433328
Name:COOK, DAVID ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLEN
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 1:4999 FRANCE AVE S
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1703
Mailing Address - Country:US
Mailing Address - Phone:612-824-7033
Mailing Address - Fax:612-285-5438
Practice Address - Street 1:4999 FRANCE AVE S
Practice Address - Street 2:SUITE 230
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1703
Practice Address - Country:US
Practice Address - Phone:612-824-7033
Practice Address - Fax:612-285-5438
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND93211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice