Individual
DR. SANDRA L SIMMONS-BOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
725 PROVIDENCE RD, CHARLOTTE, NC 28207-2370
(704) 376-1696
(704) 376-1698
Mailing address
2304 ARDEN GATE LN, CHARLOTTE, NC 28262-4482
(704) 503-4256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6088
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-27-972
STATE EMPLOYEE ID
NC
05
—
8997795
—
NC
01
—
BCBS97795
BLUE CROSS BLUE SHIELD PR
NC
Enumeration date
08/12/2006
Last updated
07/08/2007
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