Healthcare Provider Details

I. General information

NPI: 1265942650
Provider Name (Legal Business Name): SIMPSON DENTAL CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16035 SW PACIFIC HWY
TIGARD OR
97224-3438
US

IV. Provider business mailing address

16035 SW PACIFIC HWY
TIGARD OR
97224-3438
US

V. Phone/Fax

Practice location:
  • Phone: 503-620-2185
  • Fax: 503-670-4863
Mailing address:
  • Phone: 503-620-2185
  • Fax: 503-670-4863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT THOMAS SIMPSON
Title or Position: PRESIDENT
Credential: DMD
Phone: 503-620-2185