| NPI | 1922173913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD THOMAS COOLEY Owner Dentist 360-424-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010079) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |