Provider Demographics
NPI:1144726134
Name:ANDREW J. COLE DDS PLLC
Entity type:Organization
Organization Name:ANDREW J. COLE DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-748-6624
Mailing Address - Street 1:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0120
Mailing Address - Country:US
Mailing Address - Phone:360-748-6624
Mailing Address - Fax:360-748-4132
Practice Address - Street 1:388 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3609
Practice Address - Country:US
Practice Address - Phone:360-748-6624
Practice Address - Fax:360-748-4132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental