Provider Demographics
NPI:1871661710
Name:SIMPSON, MICHELE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 MASONBORO HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-4156
Mailing Address - Country:US
Mailing Address - Phone:910-791-7911
Mailing Address - Fax:910-791-7911
Practice Address - Street 1:3317 MASONBORO LOOP RD UNIT 140
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-2970
Practice Address - Country:US
Practice Address - Phone:910-791-7911
Practice Address - Fax:910-791-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8032122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist