Organization
D SIM SICELOFF DDS PA
Active
Other names
D Sim Siceloff III DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SIMEON SICELOFF III DDS (PRESIDENT)
(336) 249-6524
Entity
Organization
Contact information
Practice address
19 EAST SECOND AVENUE, LEXINGTON, NC 27292
(336) 249-6524
(336) 248-1060
Mailing address
PO BOX 848, 19 EAST SECOND AVENUE, LEXINGTON, NC 27292
(336) 249-6524
(336) 248-1060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8997790
—
NC
Enumeration date
11/01/2006
Last updated
04/08/2008
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