Individual
DR. JOHN JOSEPH SIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
260 COMMERCE ST, EDDYVILLE, KY 42038-8294
(270) 388-9712
(270) 388-9713
Mailing address
PO BOX 530, EDDYVILLE, KY 42038-0530
(270) 388-9712
(270) 388-9713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4867
KY
1223G0001X
General Practice Dentistry
Primary
4867
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45003589
—
KY
05
—
60048675
—
KY
Enumeration date
02/20/2007
Last updated
11/29/2007
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