Individual
DR. JENNIFER KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
15160 NW LAIDLAW ROAD, SUITE 202, PORTLAND, OR 97229-7707
(503) 533-2330
(503) 533-2331
Mailing address
15160 NW LAIDLAW RD, SUITE 202, PORTLAND, OR 97229-7707
(503) 533-2330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7240
OR
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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