Provider Demographics
NPI:1164678314
Name:DR. ROBERT R. SIMPSON, INC
Entity Type:Organization
Organization Name:DR. ROBERT R. SIMPSON, INC
Other - Org Name:FAMILY & COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-342-6162
Mailing Address - Street 1:255 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164
Mailing Address - Country:US
Mailing Address - Phone:304-273-5301
Mailing Address - Fax:304-273-0966
Practice Address - Street 1:255 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-1849
Practice Address - Country:US
Practice Address - Phone:304-273-5301
Practice Address - Fax:304-273-0966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. ROBERT R. SIMPSON, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty