Provider Demographics
NPI:1710690524
Name:MICHELLE COMROE DDS INC
Entity Type:Organization
Organization Name:MICHELLE COMROE DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COMROE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-941-0246
Mailing Address - Street 1:1632 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6304
Mailing Address - Country:US
Mailing Address - Phone:310-941-0246
Mailing Address - Fax:
Practice Address - Street 1:4201 TORRANCE BLVD STE 460
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4515
Practice Address - Country:US
Practice Address - Phone:310-941-0246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental