Organization
TODD T COOLEY DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD THOMAS COOLEY DDS (OWNER DENTIST)
(360) 424-8884
Entity
Organization
Contact information
Practice address
2124 RIVERSIDE DR, SUITE 108, MOUNT VERNON, WA 98273
(360) 424-8884
(360) 424-1640
Mailing address
2124 RIVERSIDE DR, SUITE 108, MOUNT VERNON, WA 98273
(360) 424-8884
(360) 424-1640
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00010079
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048459
—
WA
Enumeration date
11/22/2006
Last updated
08/22/2020
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