Provider Demographics
NPI:1689946501
Name:ERIC C. SIMPSON D.D.S., P.C.
Entity Type:Organization
Organization Name:ERIC C. SIMPSON D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PC
Authorized Official - Phone:406-293-7768
Mailing Address - Street 1:219 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2047
Mailing Address - Country:US
Mailing Address - Phone:406-293-7768
Mailing Address - Fax:406-293-9121
Practice Address - Street 1:219 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2047
Practice Address - Country:US
Practice Address - Phone:406-293-7768
Practice Address - Fax:406-293-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty