Provider Demographics
NPI:1730537663
Name:SIMMONS, WILLIAM E (X-2)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:X-2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 POPE AVE
Mailing Address - Street 2:US ARMY DENTAL ACTIVITY
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-2332
Mailing Address - Country:US
Mailing Address - Phone:913-684-5516
Mailing Address - Fax:
Practice Address - Street 1:520 POPE AVE
Practice Address - Street 2:US ARMY DENTAL ACTIVITY
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-2332
Practice Address - Country:US
Practice Address - Phone:913-684-5516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant