Individual
LEO CHOTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15885 SW 116TH AVE, TIGARD, OR 97224-2647
(503) 639-5025
Mailing address
1010 SE 11TH AVE APT 402, PORTLAND, OR 97214-2575
(530) 605-9175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11413
OR
Other
Enumeration date
08/26/2020
Last updated
02/14/2023
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