Individual
DR. KING CHEONG BRIAN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2011 CEDAR ST, FOREST GROVE, OR 97116-1701
(503) 357-5221
Mailing address
1150 NW QUIMBY ST UNIT 304, PORTLAND, OR 97209-2488
(808) 728-8867
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
61440
KS
1223G0001X
General Practice Dentistry
61440
KS
1223G0001X
General Practice Dentistry
Primary
D10874
OR
Other
Enumeration date
07/04/2017
Last updated
09/22/2021
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