Individual
DR. LICH VAN KHUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12520 SW 1ST ST, BEAVERTON, OR 97005-0550
(503) 646-5230
(503) 626-1813
Mailing address
12520 SW 1ST ST, BEAVERTON, OR 97005-0550
(503) 646-5230
(503) 626-1813
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7551
OR
Other
Enumeration date
12/28/2006
Last updated
09/22/2016
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