Provider Demographics
NPI:1083885297
Name:SIMPER, SEAN FRANK MAXWELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:FRANK MAXWELL
Last Name:SIMPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2469 QUEENSGATE DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9120
Mailing Address - Country:US
Mailing Address - Phone:509-628-1144
Mailing Address - Fax:
Practice Address - Street 1:2469 QUEENSGATE DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9120
Practice Address - Country:US
Practice Address - Phone:509-628-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60023578122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist