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
Phone: (336) 249-6524
Fax: (336) 238-1060
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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