Provider Demographics
NPI:1255461315
Name:SIMPSON, RICHARD ALLEN (DMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALLEN
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 RICE MINE RD NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2401
Mailing Address - Country:US
Mailing Address - Phone:205-758-3341
Mailing Address - Fax:205-758-0846
Practice Address - Street 1:221 RICE MINE RD NE
Practice Address - Street 2:SUITE A
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2401
Practice Address - Country:US
Practice Address - Phone:205-758-3341
Practice Address - Fax:205-758-0846
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL47381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51034677OtherBLUECROSS BLUESHIELD #