Organization
LAS CRUCES SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH CRAIG COOMBS DDS, MS (ORTHODONTIST/OWNER)
(575) 640-3367
Entity
Organization
Contact information
Practice address
1160 COMMERCE DR STE B, LAS CRUCES, NM 88011-8209
(575) 640-3367
Mailing address
1160 COMMERCE DR STE B, LAS CRUCES, NM 88011-8209
(575) 640-3367
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD4079
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023267796
INDIVIDUAL NPI NUMBER
NM
Enumeration date
07/27/2015
Last updated
10/13/2015
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