Organization
COOLEY PROSTHETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID COOLEY (OWNER)
(605) 716-9061
Entity
Organization
Contact information
Practice address
2525 W MAIN ST STE 205, RAPID CITY, SD 57702-2439
(605) 716-9061
Mailing address
2525 W MAIN ST STE 205, RAPID CITY, SD 57702-2439
(605) 716-9061
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
M755
SD
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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