Individual
DR. LENNIE D WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4095 SW 144TH AVE STE A, BEAVERTON, OR 97005-2368
(503) 643-4719
(503) 626-9488
Mailing address
4095 SW 144TH AVE STE A, BEAVERTON, OR 97005-2368
(503) 643-4719
(503) 626-9488
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6960
OR
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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