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Individual
IAN CHARLES MCCOMB
Active
Individual
IAN CHARLES MCCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019029867
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
021003032
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2901022524
MI
Other
Enumeration date
04/03/2014
Last updated
05/25/2022
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