# KENT B. SIMMONS DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326441411
- **Authorized official:** KENT B. SIMMONS D.D.S (DENTIST)
- **Authorized official phone:** (208) 746-3694

## Contact information

- **Practice address:** 3318 4TH ST, LEWISTON, ID 83501-4405
- **Practice address phone:** (208) 746-3694
- **Practice address fax:** (208) 743-8313
- **Mailing address:** 3318 4TH ST, LEWISTON, ID 83501-4405
- **Mailing address phone:** (208) 746-3694
- **Mailing address fax:** (208) 743-8313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3884 | ID | Yes |

## Other

- **Enumeration date:** 10/02/2014
- **Last updated:** 10/02/2014