Provider Demographics
NPI:1063744050
Name:SIMPSON, HAROLD VON
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:VON
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N CENTRAL EXPY
Mailing Address - Street 2:1108
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5332
Mailing Address - Country:US
Mailing Address - Phone:972-235-8555
Mailing Address - Fax:
Practice Address - Street 1:100 N CENTRAL EXPY
Practice Address - Street 2:SUITE 1108
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5332
Practice Address - Country:US
Practice Address - Phone:972-235-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry