Provider Demographics
NPI:1811022072
Name:SIMONE, PATRICK A (DDS MAGD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:A
Last Name:SIMONE
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 N PECOS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7341
Mailing Address - Country:US
Mailing Address - Phone:702-735-2755
Mailing Address - Fax:702-735-7901
Practice Address - Street 1:70 N PECOS RD
Practice Address - Street 2:SUITE A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7341
Practice Address - Country:US
Practice Address - Phone:702-735-2755
Practice Address - Fax:702-735-7901
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV23391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice