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Contact Information

FRED H SIMONTON III, DMD
1221 SHERWOOD PARK DR NE STE C
GAINESVILLE, GA30501-3404
 Phone: 770-531-1075
 Fax: 770-536-2815
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for FRED H SIMONTON III · (Male)

NPI Number 1578674271
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 08/31/2006
Last updated 01/29/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 010367
  • GA License # 10367
  • GA Medicaid 000344462A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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