Organization
DENNIS L. SIMONSEN DMD PC
Active
Other names
Simonsen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS L. SIMONSEN DMD (DENTIST)
(503) 646-3169
Entity
Organization
Contact information
Practice address
14125 SW FARMINGTON RD, BEAVERTON, OR 97005-2567
(503) 646-3169
(503) 646-1667
Mailing address
14125 SW FARMINGTON RD, BEAVERTON, OR 97005-2567
(503) 646-3169
(503) 646-1667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8454
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104816529
NATIONAL PROVIDER ID
OR
Enumeration date
05/19/2008
Last updated
08/06/2014
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