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General NPI Number Information
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NPI Number | 1356775316
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Entity Type | Organization
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Legal Business Name | DANIELLE L SIM DMD PC
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 3901 MAIN ST STE 211
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City | FLUSHING
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State | NY
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Zip | 11354-5435
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Country | US
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Telephone | 718-710-1893
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 MAIN ST STE 211
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City | FLUSHING
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State | NY
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Zip | 11354-5435
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Country | US
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Telephone | 718-710-1893
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIELLE L SIM
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Credential | DMD
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Telephone | 718-710-1893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054654
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License Number State | NY
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