Provider Demographics
NPI:1215191564
Name:SIMS, LAWRENCE OLIVER (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:OLIVER
Last Name:SIMS
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 1:7000 PEACHTREE DUNWOODY RD.
Mailing Address - Street 2:BULIDING 12 SUITE 100
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:770-286-9552
Mailing Address - Fax:
Practice Address - Street 1:8613 ROSWELL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-1896
Practice Address - Country:US
Practice Address - Phone:770-998-8089
Practice Address - Fax:678-669-1838
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8384122300000X
GA0083841223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics