# HOLME T. COOLEY DDS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Longwood Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225107139
- **Authorized official:** DR. HOLME TRUONG COOLEY D.D.S. (OWNER)
- **Authorized official phone:** (714) 491-1338

## Contact information

- **Practice address:** 898 S ANAHEIM BLVD, ANAHEIM, CA 92805-5205
- **Practice address phone:** (714) 491-1338
- **Practice address fax:** (714) 491-9258
- **Mailing address:** 898 S ANAHEIM BLVD, ANAHEIM, CA 92805-5205
- **Mailing address phone:** (714) 491-1338
- **Mailing address fax:** (714) 491-9258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 40564 | CA | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | G93533 | — | CA |