Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 8384 | GA |
N | 1223P0700X | Prosthodontist | 008384 | GA |
NPI | 1215191564 |
---|---|
Provider Name | Dr. Lawrence Oliver Sims |
First Address | Sandy Springs, GA 30328 |
Second Address | Atlanta, GA 30350-1896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2008 |
Last Update Date | 23/01/2017 |