Provider Demographics
NPI:1730887738
Name:BERNARD LABOMBARD DDS PLC
Entity type:Organization
Organization Name:BERNARD LABOMBARD DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LABOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-893-5711
Mailing Address - Street 1:1012 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7975
Mailing Address - Country:US
Mailing Address - Phone:989-893-5711
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1012 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7975
Practice Address - Country:US
Practice Address - Phone:989-893-5711
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty