Provider Demographics
NPI:1336485903
Name:SIMS, ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
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 1:8865 STANFORD BLVD
Mailing Address - Street 2:SUITE 131
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5420
Mailing Address - Country:US
Mailing Address - Phone:141-087-2087
Mailing Address - Fax:
Practice Address - Street 1:8865 STANFORD BLVD
Practice Address - Street 2:SUITE 131
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5420
Practice Address - Country:US
Practice Address - Phone:141-087-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-29
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09321122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist