Most Relevant Information
Provider Data
| NPI Number: | 1003822933 |
| Provider Name: | PENNY LEE JOHNSON R.D.H. |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 0883 |
Most Important Dates
| Enumeration Date: | 07/31/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
11281 SE STEVENS RD APT 203
PORTLAND
OR
972668314
Practice Location Phone/Fax
| Phone: | 5034818240 |
| Fax: |
Provider Mailing Location
11281 SE STEVENS RD APT 203
PORTLAND
OR
972668314
Provider Mailing Phone/Fax
| Phone: | 5034818240 |
| Fax: |