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General NPI Number Information
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NPI Number | 1528570157
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Entity Type | Organization
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Legal Business Name | SIMLEY DENTAL-LANCASTER PLLC
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 11/05/2017
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Provider Practice Location Address
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Address Line | 1445 W PLEASANT RUN RD
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City | LANCASTER
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State | TX
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Zip | 75146-1308
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Country | US
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Telephone | 847-373-8819
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 INDEPENDENCE PKWY APT 1002
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City | PLANO
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State | TX
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Zip | 75025-8217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SONYMEENA I SETTI
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Credential | DDS
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Telephone | 847-373-8819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31561
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License Number State | TX
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