Provider Demographics
NPI:1164728085
Name:SIMPSON, CASSY SMITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASSY
Middle Name:SMITH
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BRYAN RD
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-9094
Mailing Address - Country:US
Mailing Address - Phone:601-443-7893
Mailing Address - Fax:
Practice Address - Street 1:407 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-3263
Practice Address - Country:US
Practice Address - Phone:601-443-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3519-09122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist