Organization
JACK D JORGENSEN DMD PS
Active
Other names
Advanced Dental Concepts
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK DENZIL JORGENSEN DMD (PRESIDENT)
(360) 892-6555
Entity
Organization
Contact information
Practice address
7107 NE VANCOUVER MALL DR, STE. #D, VANCOUVER, WA 98661-8178
(360) 892-6555
(360) 892-4170
Mailing address
7107 NE VANCOUVER MALL DR, STE. #D, VANCOUVER, WA 98661-8178
(360) 892-6555
(360) 892-4170
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE00009473
WA
Other
Enumeration date
09/04/2006
Last updated
08/22/2020
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