Provider Demographics
NPI:1023620465
Name:SIMMONS, BRITTANY LYNN (DMD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4441
Mailing Address - Country:US
Mailing Address - Phone:717-725-7950
Mailing Address - Fax:
Practice Address - Street 1:622 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RED LION
Practice Address - State:PA
Practice Address - Zip Code:17356-2624
Practice Address - Country:US
Practice Address - Phone:717-244-8537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0428631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice