Organization
NICOLLET 38TH ST DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W SIMS DDS (DENTIST / OWNER)
(612) 825-7835
Entity
Organization
Contact information
Practice address
17 E 38TH ST, MINNEAPOLIS, MN 55409-1341
(612) 825-7835
(612) 825-3819
Mailing address
17 E 38TH ST, MINNEAPOLIS, MN 55409-1341
(612) 825-7835
(612) 825-3819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9005
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174638613
NPI DR WARREN
MN
01
—
143320200
MA
MN
01
—
156718700
NPI DR SIMS
MN
01
—
1568465441
NPI DR WILLIAMS
MN
Enumeration date
06/19/2008
Last updated
06/19/2008
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