Provider Demographics
NPI:1437731080
Name:COMISO, VERLY M
Entity Type:Individual
Prefix:
First Name:VERLY
Middle Name:M
Last Name:COMISO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3813 MOOSEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-2805
Mailing Address - Country:US
Mailing Address - Phone:916-769-4422
Mailing Address - Fax:
Practice Address - Street 1:228 BEEMAN PL
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-7009
Practice Address - Country:US
Practice Address - Phone:785-239-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant