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General NPI Number Information
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NPI Number | 1982083549
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Entity Type | Organization
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Legal Business Name | DENNIS SIMCIK DDS,PC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 149 W HARVARD ST STE 101
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City | FORT COLLINS
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State | CO
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Zip | 80525-2186
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Country | US
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Telephone | 970-223-9790
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Fax | 970-223-9791
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Provider Business Mailing Address
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Address Line | 149 W HARVARD ST STE 101
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City | FORT COLLINS
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State | CO
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Zip | 80525-2186
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Country | US
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Telephone | 970-223-9790
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Fax | 970-223-9791
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. DENNIS L SIMCIK
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Credential | DDS
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Telephone | 970-223-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8621
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License Number State | CO
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