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1548338684
JERRY WAYNE LEONARD, JR.
PORTLAND, OR
NPI
1548338684
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: OR D7672)
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
Dr. JERRY WAYNE LEONARD, JR. D.M.D.
5329 NE M L KING BLVD
PORTLAND, OR 97211-3237
Phone number: 503-988-3664
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Mailing Address
Dr. JERRY WAYNE LEONARD, JR. D.M.D.
25796 SW CANYON CREEK RD APT D304
WILSONVILLE, OR 97070-9659
Phone number: 503-682-5612
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