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Contact Information

COREY L BRIMACOMBE, DDS
413 N 17TH AVE
WAUSAU, WI54401-4226
 Phone: 715-842-4649
 Fax: 715-842-7331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for COREY L BRIMACOMBE · (Male)

NPI # 1659596153
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/17/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 5059
  • WI Medicaid 33756600
  • WI Other 5059 DELTA WI ID#
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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