Individual
DR. ETHAN ZACHARY SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
904 SPIVEY RD, WHITEVILLE, NC 28472-2915
(910) 642-6500
Mailing address
PO BOX 367, LAKE WACCAMAW, NC 28450-0367
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/14/2020
Last updated
05/06/2021
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