Individual
DR. CLETUS H. SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
565 MAIN STREET, BUNN, NC 27508
(919) 729-1103
(919) 729-1105
Mailing address
PO BOX 338, BUNN, NC 27508
(919) 729-1103
(919) 729-1105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8031
NC
1223G0001X
General Practice Dentistry
8031
NC
1223P0221X
Pediatric Dentistry
8031
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560794933
TAX ID #
NC
05
—
800285780
—
NC
Enumeration date
11/10/2005
Last updated
01/26/2023
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