Provider Demographics
NPI:1972918449
Name:CRAIG B. SIMMONS DDS PLLC
Entity Type:Organization
Organization Name:CRAIG B. SIMMONS DDS PLLC
Other - Org Name:SPOKANE DENTURES AND DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:B
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-838-2836
Mailing Address - Street 1:9506 N NEWPORT HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1219
Mailing Address - Country:US
Mailing Address - Phone:509-838-2836
Mailing Address - Fax:
Practice Address - Street 1:9506 N NEWPORT HWY
Practice Address - Street 2:SUITE B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1219
Practice Address - Country:US
Practice Address - Phone:509-838-2836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00009553122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty