MEDICARE: DR. WILLIAM SIDNEY COMBS 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	122300000X	Dentist	22211	CA

General Provider Information

NPI Number	:	1235132127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM SIDNEY COMBS D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 623
Second Line	:
City	:	POWAY
State	:	CA
Zip	:	92074-0623
Country	:	US
Telephone Number	:	858-748-2364
Fax Number	:

Provider Business Practice Location Address
First Line	:	13525 MIDLAND RD
Second Line	:	STE A
City	:	POWAY
State	:	CA
Zip	:	92064-4746
Country	:	US
Telephone Number	:	858-748-2364
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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