Provider Demographics
NPI:1578576195
Name:SIMPSON, RICHARD LEE (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
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 1:5352 HIGHWAY 25
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7505
Mailing Address - Country:US
Mailing Address - Phone:601-919-0310
Mailing Address - Fax:
Practice Address - Street 1:5352 HIGHWAY 25
Practice Address - Street 2:SUITE 1900
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-7505
Practice Address - Country:US
Practice Address - Phone:601-919-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3262-031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics