Willard Lee Simons, DDS

Individual provider Active NPI General Practice Dentistry · Cuba, NY

NPI 1740356302 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1740356302
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
030047 (NY)
Practice address
130 West Main Street
Cuba, NY 14727
Phone
(585) 968-3170
Fax
(585) 968-3171
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 030047 NY Yes

Addresses

Primary practice location

130 West Main Street
Cuba, NY 14727

Mailing address

130 West Main Street
Cuba, NY 14727
Phone (585) 968-3170

Other providers in Cuba, NY

All providers in Cuba, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.