Provider Demographics
NPI:1376932749
Name:COMBS ORTHDONTICS
Entity Type:Organization
Organization Name:COMBS ORTHDONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:509-624-1139
Mailing Address - Street 1:418 E 30TH AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2577
Mailing Address - Country:US
Mailing Address - Phone:509-624-1139
Mailing Address - Fax:509-624-4617
Practice Address - Street 1:418 E 30TH AVE
Practice Address - Street 2:STE 2
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2577
Practice Address - Country:US
Practice Address - Phone:509-624-1139
Practice Address - Fax:509-624-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty