Provider Demographics
NPI:1912164617
Name:SIMONSON, JOSEPH THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:THOMAS
Last Name:SIMONSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W HOLLIS ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1358
Mailing Address - Country:US
Mailing Address - Phone:603-882-8980
Mailing Address - Fax:603-886-0253
Practice Address - Street 1:505 W HOLLIS ST
Practice Address - Street 2:SUITE 212
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1358
Practice Address - Country:US
Practice Address - Phone:603-882-8980
Practice Address - Fax:603-886-0253
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH19321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice