MEDICARE: DR. RYAN PATRICK COOMBS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5657	OK
2	122300000X	Dentist	4505	NV

General Provider Information

NPI Number	:	1215091137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN PATRICK COOMBS D.D.S.

Provider Business Mailing Address
First Line	:	525 W WASHINGTON ST
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-3804
Country	:	US
Telephone Number	:	775-882-4247
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 W WASHINGTON ST
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89703-3804
Country	:	US
Telephone Number	:	775-882-4247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	11/10/2015

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Directions to “ DR. RYAN PATRICK COOMBS D.D.S.” Practice Location

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