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General NPI Number Information
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NPI Number | 1265652077
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Entity Type | Organization
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Legal Business Name | CRAIG L. COOMBS D.D.S., PC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2185 ROBINS DR SUITE 203
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City | LAYTON
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State | UT
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Zip | 84041-1154
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Country | US
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Telephone | 801-773-5836
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Fax | 801-773-5730
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Provider Business Mailing Address
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Address Line | 2185 ROBINS DR SUITE 203
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City | LAYTON
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State | UT
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Zip | 84041-1154
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Country | US
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Telephone | 801-773-5836
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Fax | 801-773-5130
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG L. COOMBS
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Credential |
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Telephone | 801-773-5836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 138105
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License Number State | UT
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