| Simonsen Dental | |
|
14125 Sw Farmington Rd Beaverton OR 97005-2567 | |
| (503) 646-3169 | |
| (503) 646-1667 |
| Full Name | Simonsen Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 14125 Sw Farmington Rd, Beaverton, Oregon |
| Authorized Official Name and Position | Dennis L. Simonsen (DENTIST) |
| Authorized Official Contact | 5036463169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Simonsen Dental 14125 Sw Farmington Rd Beaverton OR 97005-2567 Ph: (503) 646-3169 | Simonsen Dental 14125 Sw Farmington Rd Beaverton OR 97005-2567 Ph: (503) 646-3169 |
| NPI Number | 1568629533 |
|---|---|
| Provider Enumeration Date | 05/19/2008 |
| Last Update Date | 08/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568629533 | NPI | - | NPPES |
| 1104816529 | Other | OR | NATIONAL PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D8454 (Oregon) | Primary |
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