Organization
SIMPLY SMILES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLTER COMBELLICK MSW, LICSW, CSW -PIP (CLINICAL COORDINATOR)
(203) 810-4041
Entity
Organization
Contact information
Practice address
27249 HWY 212, LA PLANT, SD 57652
(032) 810-4041
Mailing address
1771 POST RD E, WESTPORT, CT 06880-5606
(203) 810-4041
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
12/18/2019
Last updated
11/16/2022
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