Provider Demographics
NPI:1770644130
Name:SIMPSON, BRIAN LLOYD (DDS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:LLOYD
Last Name:SIMPSON
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 1:2719 58TH ST CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-858-7975
Mailing Address - Fax:
Practice Address - Street 1:1901 S UNION
Practice Address - Street 2:SUITE B5001
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1805
Practice Address - Country:US
Practice Address - Phone:253-572-6402
Practice Address - Fax:253-572-9590
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist