Individual
MARK JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
19369 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 806-7162
(623) 806-7010
Mailing address
19369 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 806-7162
(623) 806-7010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2376
AZ
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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