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General NPI Number Information
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NPI Number | 1467437822
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Entity Type | Individual
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Provider Name | DENNIS W COOMBS M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 125 MASCOMA ST
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City | LEBANON
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State | NH
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Zip | 03766-2647
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Country | US
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Telephone | 603-443-9508
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Fax | 603-443-9549
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Provider Business Mailing Address
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Address Line | 397 HANOVER CENTER RD
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City | ETNA
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State | NH
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Zip | 03750-4213
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Country | US
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Telephone | 603-443-9508
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Fax | 603-443-9549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5506
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License Number State | NH
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