Dr. Rowdy J Simon, DDS
Dentist, General Practice in Vian, OK. Individual provider (NPI-1).
NPI number1124883335
StatusActive
Last updated in NPPESJul 1, 2024
Details
- NPI
- 1124883335
- Entity type
- Individual (NPI-1)
- Name
- Dr. Rowdy J Simon
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 16, 2024
- Certification date
- Jul 1, 2024
- Last updated
- Jul 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 7861 | OK | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | OK |
Practice location
720 S Thornton StVian, OK 74962
Phone 918-773-6200
Mailing address
96940 S 4507 RdVian, OK 74962-1672
Phone 918-773-7121
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