Provider Demographics
NPI:1871698076
Name:SIMONS, TRACI T (DDS , MS)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:T
Last Name:SIMONS
Suffix:
Gender:F
Credentials:DDS , MS
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Mailing Address - Street 1:2305 W WILLIAM CANNON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5319
Mailing Address - Country:US
Mailing Address - Phone:512-444-3494
Mailing Address - Fax:512-444-3864
Practice Address - Street 1:2305 W WILLIAM CANNON DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5319
Practice Address - Country:US
Practice Address - Phone:512-444-3494
Practice Address - Fax:512-444-3864
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX190231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry