Provider Demographics
NPI:1225029671
Name:SIMS, LAWRENCE ELLIOTT (DDS MSD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ELLIOTT
Last Name:SIMS
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 S ATLANTA PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1709
Mailing Address - Country:US
Mailing Address - Phone:918-742-7361
Mailing Address - Fax:918-742-1822
Practice Address - Street 1:2117 S ATLANTA PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1709
Practice Address - Country:US
Practice Address - Phone:918-742-7361
Practice Address - Fax:918-742-1822
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics