Provider Demographics
NPI:1851439970
Name:SIMS, PAUL G (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:SIMS
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 1:775 W GOLD ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2319
Mailing Address - Country:US
Mailing Address - Phone:406-723-8204
Mailing Address - Fax:406-723-8382
Practice Address - Street 1:775 W GOLD ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2319
Practice Address - Country:US
Practice Address - Phone:406-723-8204
Practice Address - Fax:406-723-8382
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT13-2431Medicaid
MT13-2431Medicaid
MTT60196Medicare UPIN