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Individual

JOHN WAYNE LEROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
4506 SE KING RD, MILWAUKIE, OR 97222
(503) 659-1337
(503) 659-6411
Mailing address
4506 SE KING RD, MILWAUKIE, OR 97222
(503) 659-1337
(503) 659-6411

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5839
OR

Other

Enumeration date
10/14/2006
Last updated
02/01/2017
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