Provider Demographics
NPI:1982083549
Name:DENNIS SIMCIK DDS,PC
Entity Type:Organization
Organization Name:DENNIS SIMCIK DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMCIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-223-9790
Mailing Address - Street 1:149 W HARVARD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2186
Mailing Address - Country:US
Mailing Address - Phone:970-223-9790
Mailing Address - Fax:970-223-9791
Practice Address - Street 1:149 W HARVARD ST STE 101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2186
Practice Address - Country:US
Practice Address - Phone:970-223-9790
Practice Address - Fax:970-223-9791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8621122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty