Provider Demographics
NPI:1609942267
Name:SIMKO, WILLIAM LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:SIMKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26777 LORAIN RD
Mailing Address - Street 2:#417
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070
Mailing Address - Country:US
Mailing Address - Phone:440-779-7292
Mailing Address - Fax:440-779-7292
Practice Address - Street 1:26777 LORAIN RD
Practice Address - Street 2:#417
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070
Practice Address - Country:US
Practice Address - Phone:440-779-7292
Practice Address - Fax:440-779-7292
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13759122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist