Individual
MICHAEL KEVIN SIMONETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9405 S AVENIDA DEL YAQUI, GUADALUPE, AZ 85283-2529
(480) 768-2000
Mailing address
290 RICHMOND AVE, BUFFALO, NY 14222-1997
(631) 356-5629
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063487
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2022
Last updated
09/20/2023
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