Provider Demographics
NPI:1558478990
Name:COOLEYS DDS PS
Entity Type:Organization
Organization Name:COOLEYS DDS PS
Other - Org Name:COOLEY SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-747-7000
Mailing Address - Street 1:4100 FACTORIA BLVD SE STE C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1262
Mailing Address - Country:US
Mailing Address - Phone:425-747-7000
Mailing Address - Fax:
Practice Address - Street 1:4100 FACTORIA BLVD SE STE C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1262
Practice Address - Country:US
Practice Address - Phone:425-747-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA80231223G0001X
WA80121223G0001X
WA34551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty