MEDICARE: DR. CHARLES H SIMPSON III D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7177	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407852908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES H SIMPSON III D.D.S.

Provider Business Mailing Address
First Line	:	800 W WILLIAMS ST
Second Line	:	STE 240
City	:	APEX
State	:	NC
Zip	:	27502-5204
Country	:	US
Telephone Number	:	919-363-8444
Fax Number	:	919-363-6391

Provider Business Practice Location Address
First Line	:	800 W WILLIAMS ST
Second Line	:	STE 240
City	:	APEX
State	:	NC
Zip	:	27502-5204
Country	:	US
Telephone Number	:	919-363-8444
Fax Number	:	919-363-6391

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/08/2007

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