| NPI | 1255544599 |
|---|---|
| Former Name | KATHLEEN MCCOMBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: UT 143309-9923) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: WA DE60413286) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2017-09-07 |