Provider Demographics
NPI:1649417775
Name:TRIBULA AND MCOMBER DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:TRIBULA AND MCOMBER DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:ZENIAN
Authorized Official - Last Name:MCOMBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-901-0555
Mailing Address - Street 1:702 CANDLEWOOD COMMONS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2174
Mailing Address - Country:US
Mailing Address - Phone:732-901-0555
Mailing Address - Fax:732-901-4773
Practice Address - Street 1:702 CANDLEWOOD COMMONS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2174
Practice Address - Country:US
Practice Address - Phone:732-901-0555
Practice Address - Fax:732-901-4773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022684001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty