| NPI | 1134509813 |
|---|---|
| Other Name | OLIVIA BASS COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MS 3889-16) |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024519) |
| 1223E0200X Dentist, Endodontics (Licence: MS ENDO-537-17) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2019-04-30 |