Individual
DR. RAYMOND LEE SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
523 8TH ST S, MOORHEAD, MN 56560-3503
(218) 236-9319
(218) 236-9319
Mailing address
523 8TH ST S, MOORHEAD, MN 56560-3503
(218) 236-9319
(218) 236-9319
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7603
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40617
ND MEDICAL ASSISTANCE
ND
01
—
61376SI
BLUE CROSS FEP
MN
01
—
989045
DSCND
ND
Enumeration date
06/20/2006
Last updated
07/08/2007
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