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Organization
SURPRISE PEDIATRIC DENTISTRY, PC
Active
Organization
SURPRISE PEDIATRIC DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATHEW O JENSEN DMD (DENTIST/OWNER)
(801) 656-7978
Entity
Organization
Contact information
Practice address
15331 W BELL RD, SUITE #112, SURPRISE, AZ 85374-4102
(602) 730-6481
(602) 730-6482
Mailing address
15331 W BELL RD, SUITE #112, SURPRISE, AZ 85374-4102
(602) 730-6481
(602) 730-6482
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D008930
AZ
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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