Individual
DR. TAMARA LYNN SIMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1912 LEXINGTON AVE N, SUITE 100, ROSEVILLE, MN 55113-6154
(651) 489-1900
Mailing address
1912 LEXINGTON AVE N, SUITE 100, ROSEVILLE, MN 55113-6154
(651) 489-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10509
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116018400
MN MEDICAL ASST
MN
01
—
171LSI
BCBS
MN
Enumeration date
01/20/2006
Last updated
05/01/2008
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