Provider Demographics
NPI:1023122751
Name:MICHAEL E. SIMONY D.D.S.P.C.
Entity type:Organization
Organization Name:MICHAEL E. SIMONY D.D.S.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIMONY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-263-9300
Mailing Address - Street 1:41700 HAYES RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5823
Mailing Address - Country:US
Mailing Address - Phone:586-263-9300
Mailing Address - Fax:586-263-0076
Practice Address - Street 1:41700 HAYES RD
Practice Address - Street 2:SUITE D
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-5823
Practice Address - Country:US
Practice Address - Phone:586-263-9300
Practice Address - Fax:586-263-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI161191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty