Individual
NICKLIS C SIMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2080 NE HWY 99 W, MCMINNVILLE, OR 97128
(503) 472-2445
(541) 764-3852
Mailing address
301 SW VALLEYS EDGE ST, MCMINNVILLE, OR 97128-5576
(541) 961-0259
(541) 764-3852
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4556
OR
1223G0001X
General Practice Dentistry
Primary
ORD4556
OR
Other
Enumeration date
07/11/2005
Last updated
05/21/2026
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