Provider Demographics
NPI:1104918119
Name:COOK, DANIEL HENRY (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HENRY
Last Name:COOK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S UNION AVE
Mailing Address - Street 2:SUITE B6005
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1702
Mailing Address - Country:US
Mailing Address - Phone:253-627-5470
Mailing Address - Fax:253-627-5474
Practice Address - Street 1:1901 S UNION AVE
Practice Address - Street 2:SUITE B6005
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1702
Practice Address - Country:US
Practice Address - Phone:253-627-5470
Practice Address - Fax:253-627-5474
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA37931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5028071Medicaid