Individual
MR. JAN ANDREW KOONING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
3549 N LOMBARD, PORTLAND, OR 97217-5901
(503) 289-9621
(503) 289-2930
Mailing address
3549 N LOMBARD, PORTLAND, OR 97217-5901
(503) 289-9621
(503) 289-2930
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D6081
OR
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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