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General NPI Number Information
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NPI Number | 1528235074
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Entity Type | Organization
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Legal Business Name | SIMPSON ORAL AND MAXILLOFACIAL SURGERY PC
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 113 N MIDDLETOWN RD
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City | NANUET
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State | NY
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Zip | 10954-1929
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Country | US
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Telephone | 845-623-3497
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Fax | 845-623-4039
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Provider Business Mailing Address
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Address Line | 113 NORTH MIDDLETOWN RD
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City | NANUET
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State | NY
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Zip | 10954
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Country | US
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Telephone | 845-623-3497
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Fax | 845-623-4039
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DIANE M CAIN
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Credential |
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Telephone | 845-623-3497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 42385
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License Number State | NY
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