Clayton Thomas Cooke, DDS
Individual provider Active NPI General Practice Dentistry · Fallbrook, CA
NPI 1508026063 · NPPES record last updated Jun 9, 2008
Key facts
- NPI
- 1508026063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 24441 (CA)
- Practice address
- 425 E Alvarado St Ste a
Fallbrook, CA 92028-2960 - Phone
- (760) 728-5011
- Fax
- (760) 728-5509
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24441 | CA | Yes |
Addresses
Primary practice location
425 E Alvarado St Ste a
Fallbrook, CA 92028-2960
Mailing address
425 E Alvarado St Ste a
Fallbrook, CA 92028-2960
Phone (760) 728-5011
Other providers in Fallbrook, CA
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- Community Health Systems, Inc.
- Community Health Systems, Inc.
- Connections Counseling and Neurofeedback
- Richard William Cooke
- Aangelina Isabel Corado
- Lisa Cornette
- Marianna Diaz Corona
- Rachel Lorainne Couch
All providers in Fallbrook, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.