# SIMPSON DENTAL OFFICES

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

## Provider details

- **NPI number:** 1952436883
- **Authorized official:** DR. CHARLES GORDON SIMPSON DDS (V PRESIDENT DENTIST)
- **Authorized official phone:** (208) 785-0310

## Contact information

- **Practice address:** 1180 PARKWAY DR, BLACKFOOT, ID 83221-1651
- **Practice address phone:** (208) 785-0310
- **Practice address fax:** (208) 785-0319
- **Mailing address:** PO BOX 869, BLACKFOOT, ID 83221-0869
- **Mailing address phone:** (208) 785-0310
- **Mailing address fax:** (208) 785-0319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D1394 | ID | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 43890 | BLUE CROSS | ID |