Provider Demographics
NPI:1801810734
Name:COMBS, GARY W (DMD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:W
Last Name:COMBS
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 1:1001 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2742
Mailing Address - Country:US
Mailing Address - Phone:606-528-7730
Mailing Address - Fax:606-528-7743
Practice Address - Street 1:1001 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2742
Practice Address - Country:US
Practice Address - Phone:606-528-7730
Practice Address - Fax:606-528-7743
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY43211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice