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General NPI Number Information
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NPI Number | 1932550894
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Entity Type | Organization
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Legal Business Name | CHRIS R. COMBS FAMILY DENTISTRY
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 06/22/2016
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Provider Practice Location Address
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Address Line | 1300 SLACK ST
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City | PEA RIDGE
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State | AR
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Zip | 72751-3914
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Country | US
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Telephone | 479-488-6131
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Fax | 479-488-6215
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Provider Business Mailing Address
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Address Line | PO BOX 810
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City | PEA RIDGE
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State | AR
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Zip | 72751-0810
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Country | US
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Telephone | 479-488-6131
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Fax | 479-488-6215
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. CHRIS R COMBS
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Credential | D.D.S., P.A.
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Telephone | 479-855-6764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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