Provider Demographics
NPI:1528232782
Name:SIMMONS, DENNIS C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:SIMMONS
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 1:8977 HUNTERS WAY
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-9486
Mailing Address - Country:US
Mailing Address - Phone:952-891-8484
Mailing Address - Fax:952-891-1256
Practice Address - Street 1:8977 HUNTERS WAY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-9486
Practice Address - Country:US
Practice Address - Phone:952-891-8484
Practice Address - Fax:952-891-1256
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND82701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN18292OtherDORAL