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General NPI Number Information
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NPI Number | 1992730063
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Entity Type | Organization
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Legal Business Name | COMAR & COMAR PC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1900 WHITES RD
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City | KALAMAZOO
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State | MI
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Zip | 49008-2895
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Country | US
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Telephone | 269-381-8419
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Fax | 269-381-1529
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Provider Business Mailing Address
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Address Line | 1900 WHITES RD
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City | KALAMAZOO
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State | MI
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Zip | 49008-2895
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Country | US
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Telephone | 269-381-8419
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Fax | 269-381-1529
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Authorized Official
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Title or Position | DENTIST PERIODONTIST
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Name | DR. TERENCE R COMAR
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Credential | DDS MS
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Telephone | 269-381-8419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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