# PHILLIP M. JENSEN, D.M.D., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134494289
- **Authorized official:** DR. PHILLIP JENSEN D.M.D. (PRESIDENT)
- **Authorized official phone:** (217) 753-8690

## Contact information

- **Practice address:** 2606 MARKETPLACE DR, SPRINGFIELD, IL 62702-1467
- **Practice address phone:** (217) 753-8690
- **Mailing address:** 2606 MARKETPLACE DR, SPRINGFIELD, IL 62702-1467
- **Mailing address phone:** (217) 753-8690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019020843 | IL | Yes |

## Other

- **Enumeration date:** 03/21/2012
- **Last updated:** 03/21/2012