Provider Demographics
NPI:1477699734
Name:SIMPSON, STEPHEN ERIC (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ERIC
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:132 HERITAGE PARK DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0564
Mailing Address - Country:US
Mailing Address - Phone:615-890-0454
Mailing Address - Fax:615-890-4882
Practice Address - Street 1:132 HERITAGE PARK DR
Practice Address - Street 2:SUITE 3
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0564
Practice Address - Country:US
Practice Address - Phone:615-890-0454
Practice Address - Fax:615-890-4882
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNDS0052041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU88781Medicare UPIN