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General NPI Number Information
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NPI Number | 1790899037
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Entity Type | Organization
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Legal Business Name | TODD T. COOLEY DDS, PLLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 2261 HOSPITAL DR. #101
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284
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Country | US
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Telephone | 360-856-6011
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Fax | 360-856-2232
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Provider Business Mailing Address
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Address Line | 2261 HOSPITAL DR. #101
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284
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Country | US
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Telephone | 360-856-6011
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Fax | 360-856-2232
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Authorized Official
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Title or Position | MEMBER OWNER
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Name | TODD THOMAS COOLEY
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Credential | DDS
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Telephone | 360-856-6011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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