Provider Demographics
NPI:1518304294
Name:COMBEST, WILLIAM BRUCE (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRUCE
Last Name:COMBEST
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 1:402 RICHMOND RD N STE C
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-1133
Mailing Address - Country:US
Mailing Address - Phone:859-986-4661
Mailing Address - Fax:958-986-3579
Practice Address - Street 1:402 RICHMOND RD N STE C
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1133
Practice Address - Country:US
Practice Address - Phone:859-986-4661
Practice Address - Fax:958-986-3579
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4573122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist