Individual
DAVID SIM SICELOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19 E 2ND AVE, LEXINGTON, NC 27292-3362
(336) 249-6524
(336) 238-1060
Mailing address
19 E 2ND AVE, LEXINGTON, NC 27292-3362
(336) 249-6524
(336) 238-1060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
NC4114
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69343
UNITED CONCORDIA
NC
05
—
8997790
—
NC
01
—
97790
BLUE CROSS BLUE SHIELD
NC
Enumeration date
01/15/2013
Last updated
01/15/2013
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