Provider Demographics
NPI:1407978752
Name:SIMPSON, JOSH L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSH
Middle Name:L
Last Name:SIMPSON
Suffix:
Gender:M
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:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0990
Mailing Address - Country:US
Mailing Address - Phone:601-684-2351
Mailing Address - Fax:601-684-9187
Practice Address - Street 1:222 3RD ST
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4102
Practice Address - Country:US
Practice Address - Phone:601-684-2351
Practice Address - Fax:601-684-9187
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3338-05122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist