Provider Demographics
NPI:1548078892
Name:COMFORT, TAMMY MARIE (RDH)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:MARIE
Last Name:COMFORT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:MOHAVE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86440-8420
Mailing Address - Country:US
Mailing Address - Phone:928-346-4679
Mailing Address - Fax:
Practice Address - Street 1:1607 PLANTATION RD
Practice Address - Street 2:
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440-8420
Practice Address - Country:US
Practice Address - Phone:928-346-4679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH06505124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist