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Individual

KRISTI COULOMBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1296 COMMERCIAL ST SE, SUITE 102, SALEM, OR 97302-4200
(503) 399-0724
Mailing address
1550 NORWAY ST NE, SALEM, OR 97301-0433
(503) 588-8251

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10053
OR
124Q00000X
Dental Hygienist
H5021
OR

Other

Enumeration date
11/29/2008
Last updated
07/08/2014
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