Provider Demographics
NPI:1760593990
Name:LENG, JOHN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:LENG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2947
Mailing Address - Country:US
Mailing Address - Phone:509-684-5066
Mailing Address - Fax:509-684-4953
Practice Address - Street 1:245 N OAK ST
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2947
Practice Address - Country:US
Practice Address - Phone:509-684-5066
Practice Address - Fax:509-684-4953
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000073931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice