Siceloff, David Sim

Siceloff, David Sim is an sole proprietor health care provider with primary practice located at 19 E 2Nd Ave , Lexington NC 27292-3362. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Siceloff, David Sim can be contacted via phone (336) 249-6524.

Contact Information

Primary practice address
19 E 2Nd Ave Lexington NC 27292-3362
Fax: (336) 238-1060
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X NC4114 North Carolina

Profile Details

NPI number 1417294109
LBN Legal business name Siceloff, David Sim
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 15th, 2013
Last updated Jan 15th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417294109 NPPES
North Carolina Other 69343 UNITED CONCORDIA
North Carolina MEDICAID 8997790 UNITED CONCORDIA
North Carolina Other 97790 UNITED CONCORDIA

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