MEDICARE: CRAIG L. COOMBS D.D.S., PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	138105	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265652077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG L. COOMBS D.D.S., PC

Provider Business Mailing Address
First Line	:	2185 ROBINS DR
Second Line	:	SUITE 203
City	:	LAYTON
State	:	UT
Zip	:	84041-1154
Country	:	US
Telephone Number	:	801-773-5836
Fax Number	:	801-773-5130

Provider Business Practice Location Address
First Line	:	2185 ROBINS DR
Second Line	:	SUITE 203
City	:	LAYTON
State	:	UT
Zip	:	84041-1154
Country	:	US
Telephone Number	:	801-773-5836
Fax Number	:	801-773-5730

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG L. COOMBS
Credential	:
Telephone Number	:	801-773-5836

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/22/2020

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