Individual
DR. NICOLE N LUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12720 SE STARK ST, PORTLAND, OR 97233-1539
(503) 252-6133
(503) 257-6886
Mailing address
10232 SE CHAMPAGNE LN, HAPPY VALLEY, OR 97086-7843
(503) 708-8059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7803
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227117
—
OR
Enumeration date
12/29/2006
Last updated
01/25/2014
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