Individual
ANGEL A SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11503 SUNRISE VALLEY DR, RESTON, VA 20191-1505
(703) 860-3200
Mailing address
5125 DELTA ST, NORTH CHARLESTON, SC 29406-6350
(843) 343-9991
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402207342
VA
124Q00000X
Dental Hygienist
3999
SC
124Q00000X
Dental Hygienist
DH12296
GA
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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