Provider Demographics
NPI:1528340858
Name:COOLEY, TODD THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:THOMAS
Last Name:COOLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 HOSPITAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-4329
Mailing Address - Country:US
Mailing Address - Phone:360-856-6011
Mailing Address - Fax:360-856-2232
Practice Address - Street 1:2261 HOSPITAL DR STE 101
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-4329
Practice Address - Country:US
Practice Address - Phone:360-856-6011
Practice Address - Fax:360-856-2232
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010079122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist