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Individual

MR. RONNIE ROY SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
924 S 1ST AVE, BROKEN BOW, NE 68822-3004
(308) 872-6294
(308) 872-6548
Mailing address
924 S 1ST AVE, BROKEN BOW, NE 68822-3004
(308) 872-6294
(308) 872-6548

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4119
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47059663800
NE
Enumeration date
11/04/2005
Last updated
07/08/2007
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