Provider Demographics
NPI:1871895243
Name:ECONOMY DENTURES PLUS
Entity type:Organization
Organization Name:ECONOMY DENTURES PLUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESDENT /OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOCOB
Authorized Official - Middle Name:P
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-874-0678
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:6363 KY ROUTE 1428
Mailing Address - City:ALLEN
Mailing Address - State:KY
Mailing Address - Zip Code:41601-0066
Mailing Address - Country:US
Mailing Address - Phone:606-874-0678
Mailing Address - Fax:
Practice Address - Street 1:6363 KY ROUTE 1428
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:KY
Practice Address - Zip Code:41601-0066
Practice Address - Country:US
Practice Address - Phone:606-874-0678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0844122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty