Basic Information
| Provider Information | |||||||||
| NPI: | 1467431049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | TONYA | ||||||||
| MiddleName: | X | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 149 KEARNY AVE | ||||||||
| Address2: | |||||||||
| City: | PERTH AMBOY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088614700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322930135 | ||||||||
| FaxNumber: | 7322930139 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 KEARNY AVE | ||||||||
| Address2: | |||||||||
| City: | PERTH AMBOY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088614700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322930135 | ||||||||
| FaxNumber: | 7322930139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2006 | ||||||||
| LastUpdateDate: | 03/28/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 20369 | NJ | Y | Dental Providers | Dentist |
No ID Information.