# TODD T. COOLEY DDS, PLLC

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

## Provider details

- **NPI number:** 1790899037
- **Authorized official:** TODD THOMAS COOLEY DDS (MEMBER OWNER)
- **Authorized official phone:** (360) 856-6011

## Contact information

- **Practice address:** 2261 HOSPITAL DR. \#101, SEDRO WOOLLEY, WA 98284
- **Practice address phone:** (360) 856-6011
- **Practice address fax:** (360) 856-2232
- **Mailing address:** 2261 HOSPITAL DR. \#101, SEDRO WOOLLEY, WA 98284
- **Mailing address phone:** (360) 856-6011
- **Mailing address fax:** (360) 856-2232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |

## Other

- **Enumeration date:** 08/17/2006
- **Last updated:** 03/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 906277 | UNITED CONCORDIA | — |