# IAN CHARLES MCCOMB

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003234287
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019029867 | IL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 021003032 | IL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 2901022524 | MI | — |

## Other

- **Enumeration date:** 04/03/2014
- **Last updated:** 05/25/2022