Provider Demographics
NPI:1487037453
Name:COOMBS, SPENCER (DMD)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:
Last Name:COOMBS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1758 FARROW DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-7760
Mailing Address - Country:US
Mailing Address - Phone:803-493-5109
Mailing Address - Fax:
Practice Address - Street 1:1758 FARROW DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-7760
Practice Address - Country:US
Practice Address - Phone:803-493-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice