Individual
NICKLIS C SIMPSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6645 GLENEDEN BEACH LOOP, GLENEDEN BEACH, OR 97388-9700
(541) 764-3850
(541) 764-3852
Mailing address
PO BOX 86, 6645 GLENEDEN BEACH LOOP, GLENEDEN BEACH, OR 97388-0086
(541) 764-3850
(541) 764-3852
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4556
OR
Other
Enumeration date
07/11/2005
Last updated
07/08/2007
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