Individual
DR. JESSICA MINTIE KLOENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
511 SW 10TH AVE, STE 804, PORTLAND, OR 97205-2732
(503) 243-2505
Mailing address
511 SW 10TH AVE STE 804, PORTLAND, OR 97205-2709
(503) 243-2505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10301
OR
Other
Enumeration date
07/20/2015
Last updated
10/30/2017
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